Abstract
The objective of the present study was to describe the incidence and the characteristics of Self-Injurious Thoughts and Behaviors (SITBs), among adolescents aged 11–18 admitted, over a two year period, to all the Emergency Departments of a Region of North-eastern Italy through a comprehensive analysis of medical records. A two-step search was performed in the regional ED electronic database. First, we identified the cases that had been clearly diagnosed as SITBs by an Emergency Department physician. Secondly, suspect cases were detected through a keyword search of the database, and the medical records of these cases were hand screened to identify SITBs. The mean annual incidence rate of SITBs was 90 per 100,000 adolescents aged 11–18 years. Events were more frequent in females. Drug poisoning was the most frequently adopted method (54%). In 42% of cases a diagnosis of SITB was not explicitly reported by the physician. In 65% of cases adolescents were discharged within hours of admission. Only 9% of patients started a psychiatric assessment and treatment program during hospital stay. This research confirms the high incidence of SITBs among adolescents and highlights the difficulty in their proper diagnosis and management. Such difficulty is confirmed by the fact that only a few patients, even among those with a clear diagnosis, were sent for psychiatric assessment. Correct identification and management of SITB patients needs to be improved, since SITBs are an important public health problem in adolescence and one of the main risk factors for suicide.
Highlights
Suicide is a major public health concern in adolescents, being the second leading cause of death in young people worldwide, [1] prevention initiatives aimed at young people, especially those at high risk, are strongly needed. [2]The current most shared opinion is to consider suicide attempts, suicide ideations and self-injurious thoughts and behaviors (SITBs) all as elements of a spectrum of increasedPLOS ONE | DOI:10.1371/journal.pone.0170979 January 26, 2017
58% of all the cases of SITBs were identified in Step 1: these were the cases in which the self-injurious intent was reported in the triage and/or in the final diagnosis sections of the medical report with a specific term such as “suicide attempt” / “self-harm”/ “self-injury”
With respect to the distribution of cases over the 24-hours, our data show that adolescents acted mainly late in the afternoon or during the evening, a finding which is confirmed by the results of other authors. [1,29,30] We found a higher frequency of SITBs in autumn and in particular in November and, for males, a lower frequency during the summer
Summary
Suicide is a major public health concern in adolescents, being the second leading cause of death in young people worldwide, [1] prevention initiatives aimed at young people, especially those at high risk, are strongly needed. [2]The current most shared opinion is to consider suicide attempts, suicide ideations and self-injurious thoughts and behaviors (SITBs) all as elements of a spectrum of increasedPLOS ONE | DOI:10.1371/journal.pone.0170979 January 26, 2017. Suicide is a major public health concern in adolescents, being the second leading cause of death in young people worldwide, [1] prevention initiatives aimed at young people, especially those at high risk, are strongly needed. The current most shared opinion is to consider suicide attempts, suicide ideations and self-injurious thoughts and behaviors (SITBs) all as elements of a spectrum of increased.
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