Emergency Presentations to Child and Adolescent Psychiatry: Nonsuicidal Self-Injury and Suicidality.

Monika Franzen,Ferdinand Keller,Paul L Plener,Rebecca C Brown

doi:10.3389/fpsyt.2019.00979

Abstract

Nonsuicidal Self-Injury (NSSI) and suicidality are common reasons for emergency presentations in child and adolescent psychiatry. Therefore, we focused on reasons for emergency presentations as well as specific characteristics of those presenting with NSSI or suicidality to an emergeny psychiatric service. We analyzed data from a German university hospital regarding emergency presentations during a 78 months' period. NSSI and suicidality were rated according to the Columbia Classification Algorithm of Suicide Assessment (C-CASA). Data from 546 emergency presentations was recorded, of which 347 (63.5%) presented for NSSI or suicidality. Given the high percentage, thorough assessment of sucidality as well as providing adequate treatment in emergency settings to establish further care, is of utmost importance.

Highlights

Nonsuicidal Self-Injury (NSSI), defined as repetitive direct self-inflicted damage of one's own body surface without suicidal intent [1], has been described repeatedly as common phenomenon in adolescents, with rates ranging between a lifetime prevalence of 18%–28% in international school samples [2, 3]
With regards to suicidality, rates of suicidal ideation have been reported to be between 19.8% and 24% in youth [5], whereas lifetime prevalence rates between 3.1% and 8.8% have been reported for suicide attempts in minors [5]
We were able to show that NSSI and suicidality are the main reasons for presenting to our child and adolescent psychiatric services

Summary

Introduction

Nonsuicidal Self-Injury (NSSI), defined as repetitive direct self-inflicted damage of one's own body surface without suicidal intent [1], has been described repeatedly as common phenomenon in adolescents, with rates ranging between a lifetime prevalence of 18%–28% in international school samples [2, 3]. Rates of NSSI have been reported to be even higher, reaching up to 50% in child and adolescent psychiatric inpatients [4]. Germany is—within Europe—among the countries with the highest rates for NSSI in adolescent scool samples, with a lifetime prevalence of 35.1% [3]. A lifetime prevalence rate for suicidal ideation of 39.4% has been reported from a representative sample of German high-school students, with 9% reporting a lifetime suicide attempt [6].

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