scholarly journals Formas utilizadas para tentativa de suicídio e características sociodemográficas de pacientes atendidos no serviço de emergência de um hospital de ensino

2016 ◽  
Vol 26 (4) ◽  
pp. 24467
Author(s):  
Betina Brixner ◽  
Caroline Lau Koch ◽  
Marla Pedroso Marth ◽  
Alice Pereira Freitas ◽  
Cristiane Carla Dressler Garske ◽  
...  
Keyword(s):  
Emergency Department ◽  
Suicide Attempt ◽  
Electronic Medical Records ◽  
Medical Records ◽  
Suicide Attempts ◽  
Care Center ◽  
Univariate Analysis ◽  
Psychosocial Care ◽  
Psychiatric Evaluation ◽  
Suicidal Patients

Aims: To assess the methods used in suicide attempts and sociodemographic characteristics of suicidal patients treated at the emergency department of a teaching hospital.Methods: Cross-sectional retrospective study, with active search for electronic medical records of patients treated at the emergency department of a public teaching hospital in the countryside of Rio Grande do Sul, Brazil, from January to December 2015. All cases of suicide attempt were included, regardless of the suicide methods used. Successful suicide cases were not investigated. The statistical analyses included descriptive statistics, univariate analysis, and Pearson’s chi-square test.Results: A total of 233 patients treated at the emergency department were referred for psychiatric evaluation, and 122 of them had attempted suicide. The mean age of the suicidal patients was 36.8±14.3 years, (minimum of 14 years and maximum of 88 years) and 74 (60.6%) of them were female. The most common suicide attempt methods were ingestion of medications (72 cases, 59%) and of pesticide (14 cases, 11.5%). Of all patients, 119 (97.5%) lived in Santa Cruz do Sul, predominantly in the urban area (103 patients, 84.4%). Of the 50 (41.0%) referrals, 32 (64.0%) were sent to the Center for Psychosocial Care, 7 (14%) to the Center for Children’s and Adolescents’ Psychosocial Care, 6 (12%) were admitted to a mental health unit, and 5 (10%) were sent to Psychosocial Care Center for Alcohol and Drug Abuse. Sixty-six (54.1%) patients had no electronic medical records of their outcome after discharge and 6 (4.9%) were lost to follow-up.Conclusions: Most of the treated suicidal patients were young adult females. The most common method of suicide attempt was the ingestion of medications, followed by the ingestion of pesticides.

scholarly journals Tentativa de suicídio entre pessoas com transtornos mentais e comportamentais

2018 ◽  
Vol 12 (5) ◽  
pp. 1289
Author(s):  
Nadja Cristiane Lappann Botti ◽  
Aline Conceição Silva ◽  
Camila Correa Matias Pereira ◽  
Luiza Cantão ◽  
Ramon Azevedo Silva Castro ◽  
...  
Keyword(s):  
Suicide Attempt ◽  
Medical Records ◽  
Psychiatric Comorbidity ◽  
Suicide Attempts ◽  
Care Center ◽  
Psychosocial Care ◽  
Traumatic Experience ◽  
History Of ◽  
Violencia Domestica ◽  
Suicide Attempted

RESUMOObjetivo: investigar a relação tentativa de suicídio e características sociodemográficas e psiquiátricas de pacientes com transtornos psiquiátricos. Método: estudo quantitativo, transversal, com 410 pacientes atendidos em um Centro de Atenção Psicossocial. Os dados foram analisados por meio de estatística descritiva e inferencial e tabulados no SPSS, versão 21.0. Resultados: dentre os 410 prontuários analisados, foram encontrados 22,9% dos prontuários com registro de tentativa de suicídio. A tentativa de suicídio foi mais frequente em homens, adultos, entre 19 e 59 anos, sem vínculo matrimonial, com baixa escolaridade e inatividade laboral. Ainda se identificou associação de tentativa de suicídio com comorbidade psiquiátrica e história de abuso físico ou sexual, acidente ou violência doméstica, violências, acidentes, perdas importantes, perdas ou separação dos pais e conflitos familiares. Conclusão: pacientes em tratamento no centro de atenção psicossocial com comorbidade psiquiátrica e história de experiência traumática apresentam maior risco de comportamento suicida. Descritores: Transtornos Mentais; Pacientes; Serviços de Saúde Mental; Adulto; Tentativa de Suicídio; Enfermagem.ABSTRACT Objective: to investigate the suicide attempt and sociodemographic and psychiatric characteristics relationship of patients with psychiatric disorders. Method: quantitative, cross-sectional study with 410 patients attended at a Psychosocial Care Center. Data was analyzed using descriptive and inferential statistics and tabulated in SPSS, version 21.0. Results: among the 410 medical records analyzed, 22.9% of the medical records with registered suicide attempts were found. The suicide attempt was more frequent in men, adults, between 19 and 59 years old, without a marital bond, with low educational levels and work inactivity. Association of suicide attempts with a psychiatric comorbidity and history of physical or sexual abuse, domestic accident or violence, violence, accidents, major losses, losses or separation of parents and family conflicts were also identified. Conclusion: patients undergoing treatment at the psychosocial care center with a psychiatric comorbidity and history of traumatic experience have a higher risk of suicidal behavior. Descritores: Mental Disorders; Patients; Mental Health Services; Adult; Suicide, Attempted; Nursing. RESUMEN Objetivo: investigar la relación entre el intento de suicidio y las características sociodemográficas y psiquiátricas de pacientes con trastornos psiquiátricos. Método: estudio cuantitativo, transversal, con 410 pacientes atendidos en un Centro de Atención Psicosocial. Los datos fueron analizados por medio de estadística descriptiva e inferencial y tabulados en el SPSS, versión 21.0. Resultados: entre los 410 prontuarios analizados, fueron encontrados el 22,9% de los prontuarios con registro de intento de suicidio. El intento de suicidio fue más frecuente en hombres, adultos, entre 19 y 59 años, sin vínculo matrimonial, con baja escolaridad e inactividad laboral. También se identificó asociación de intento de suicidio con comorbilidad psiquiátrica e historia de abuso físico o sexual, accidente o violencia doméstica, violencias, accidentes, pérdidas importantes, pérdidas o separación de los padres y conflictos familiares. Conclusión: pacientes en tratamiento en el centro de atención psicosocial con comorbilidad psiquiátrica e historia de experiencia traumática presentan mayor riesgo de comportamiento suicida. Descritores: Trastornos Mentales; Pacientes; Servicios de Salud Mental; Adulto; Intento de Suicidio; Enfermería.

Analysis of Deliberate Self-Wrist-Cutting Episodes Presenting to the Emergency Department

Crisis ◽  
2016 ◽  
Vol 37 (2) ◽  
pp. 155-160 ◽  
Author(s):  
Jin Kim ◽  
Han Joon Kim ◽  
Soo Hyun Kim ◽  
Sang Hoon Oh ◽  
Kyu Nam Park
Keyword(s):  
Emergency Department ◽  
Medical Records ◽  
Attempted Suicide ◽  
Suicide Attempts ◽  
Psychiatric Interview ◽  
Clinical Variables ◽  
Completed Suicide ◽  
Number Of Patients ◽  
Group A ◽  
Efficacy Of Treatment

Abstract. Background: Previous suicide attempts increase the risk of a completed suicide. However, a large proportion of patients with deliberate self-wrist cutting (DSWC) are often discharged without undergoing a psychiatric interview. Aims: The aims of this study were to investigate the differences in the characteristics and outcomes of patients with DSWC and those with deliberate self-poisoning (DSP) episodes. The results of this study may be used to improve the efficacy of treatment for DSWC patients. Method: We retrospectively reviewed the medical records of 598 patients with DSWC and DSP who were treated at the emergency department of Seoul Saint Mary's Hospital between 2008 and 2013. We assessed sociodemographic information, clinical variables, the reasons for the suicide attempts, and the severity of the suicide attempts. Results: A total of 141 (23.6%) patients were included in the DSWC group, and 457 (76.4%) were included in the DSP group. A significantly greater number of patients in the DSWC group had previously attempted suicide (p = .014). A total of 63 patients (44.7%) in the DSWC group and 409 patients (89.5%) in the DSP group underwent psychiatric interviews. Conclusion: More DSWC patients had previously attempted suicide, but fewer of them underwent psychiatric interviews compared with the DSP patients.

scholarly journals Genetic Modifiers of Hereditary Neuromuscular Disorders and Cardiomyopathy

Cells ◽  
2021 ◽  
Vol 10 (2) ◽  
pp. 349
Author(s):  
Sholeh Bazrafshan ◽  
Hani Kushlaf ◽  
Mashhood Kakroo ◽  
John Quinlan ◽  
Richard C. Becker ◽  
...  
Keyword(s):  
Muscular Dystrophy ◽  
Electronic Medical Records ◽  
Cardiac Disease ◽  
Medical Records ◽  
Care Center ◽  
Neuromuscular Disorders ◽  
Next Generation Sequencing Data ◽  
Comparative Genomic ◽  
Genetic Modifiers ◽  
Cardiac Phenotype

Novel genetic variants exist in patients with hereditary neuromuscular disorders (NMD), including muscular dystrophy. These patients also develop cardiac manifestations. However, the association between these gene variants and cardiac abnormalities is understudied. To determine genetic modifiers and features of cardiac disease in NMD patients, we have reviewed electronic medical records of 651 patients referred to the Muscular Dystrophy Association Care Center at the University of Cincinnati and characterized the clinical phenotype of 14 patients correlating with their next-generation sequencing data. The data were retrieved from the electronic medical records of the 14 patients included in the current study and comprised neurologic and cardiac phenotype and genetic reports which included comparative genomic hybridization array and NGS. Novel associations were uncovered in the following eight patients diagnosed with Limb-girdle Muscular Dystrophy, Bethlem Myopathy, Necrotizing Myopathy, Charcot-Marie-Tooth Disease, Peripheral Polyneuropathy, and Valosin-containing Protein-related Myopathy. Mutations in COL6A1, COL6A3, SGCA, SYNE1, FKTN, PLEKHG5, ANO5, and SMCHD1 genes were the most common, and the associated cardiac features included bundle branch blocks, ventricular chamber dilation, septal thickening, and increased outflow track gradients. Our observations suggest that features of cardiac disease and modifying gene mutations in patients with NMD require further investigation to better characterize genotype–phenotype relationships.

scholarly journals Healthcare Utilization Due to Suicide Attempts among Homeless Youth in New York State

2021 ◽  
Author(s):  
Rie Sakai-Bizmark ◽  
Hiraku Kumamaru ◽  
Dennys Estevez ◽  
Emily H Marr ◽  
Edith Haghnazarian ◽  
...  
Keyword(s):  
Emergency Department ◽  
New York ◽  
Length Of Stay ◽  
Suicide Attempt ◽  
Healthcare Utilization ◽  
Regression Models ◽  
Homeless Youth ◽  
Suicide Attempts ◽  
New York State ◽  
Individual Characteristics

Abstract Suicide remains the leading cause of death among homeless youth. We assessed differences in healthcare utilization between homeless and non-homeless youth presenting to the emergency department or hospital after a suicide attempt. New York Statewide Inpatient and Emergency Department Databases (2009–2014) were used to identify homeless and non-homeless youth ages 10 to 17 who utilized healthcare services following a suicide attempt. To evaluate associations with homelessness, we used logistic regression models for mortality, use of violent means, intensive care unit utilization, log-transformed linear regression models for hospitalization cost, and negative binomial regression models for length of stay. All models were adjusted by individual characteristics with a hospital random effect and year fixed effect. We identified 18,026 suicide attempts with healthcare utilization rates of 347.2 (95% Confidence Interval [CI]: 317.5, 377.0) and 67.3 (95%CI: 66.3, 68.3) per 100,000 person-years for homeless and non-homeless youth, respectively. Length of stay for homeless youth was statistically longer than non-homeless youth (Incidence Rate Ratio 1.53; 95%CI: 1.32, 1.77). All homeless youth who visited the emergency department after a suicide attempt were subsequently hospitalized. This could suggest a higher acuity upon presentation among homeless youth compared with non-homeless youth. Interventions tailored to homeless youth should be developed.

scholarly journals Medical Trainee Continuity of Care Following Emergency Department Consultations in a Pediatric Hospital

2016 ◽  
Vol 8 (1) ◽  
pp. 33-38 ◽  
Author(s):  
Kim Bjorklund ◽  
Emily A. Eismann ◽  
Roger Cornwall
Keyword(s):  
Emergency Department ◽  
Continuity Of Care ◽  
Broad Spectrum ◽  
Medical Records ◽  
Care Center ◽  
Tertiary Care ◽  
Well Being ◽  
Tertiary Care Center ◽  
Pediatric Hospital ◽  
Medical Trainee

ABSTRACT Background The importance of continuity of care in training is widely recognized; however, a broad-spectrum assessment across all specialties has not been performed. Objective We assessed the continuity of care provided by trainees, following patient consultations in the emergency department (ED) across all specialties at a large pediatric tertiary care center. Methods Medical records were reviewed to identify patients seen in consultation by a resident or fellow trainee in the ED over a 1-year period, and to determine if the patient followed up with the same trainee for the same condition during the next 6 months. Results Resident and fellow trainees from 33 specialties participated in 3400 ED consultations. Approximately 50% (1718 of 3400) of the patients seen in consultation by a trainee in the ED followed up with the same specialty within 6 months, but only 4.1% (70 of 1718) followed up with the same trainee for the same condition. Trainee continuity of care ranged from 0% to 21% among specialties, where specialties with resident clinics (14.4%) have a greater continuity of care than specialties without resident clinics (2.7%, P < .001). Continuity of care did not differ between fellows (4.2%) and residents (4.0%, P = .87), but did differ between postgraduate years for residents (P < .001). Conclusions Trainee continuity of care for ED consultations was low across all specialties and levels of training. If continuity of care is important for patient well-being and trainee education, efforts to improve continuity for trainees must be undertaken.

scholarly journals Risks of suicide attempts after prescription of zolpidem in people with depression: a nationwide population study in South Korea

SLEEP ◽  
2019 ◽  
Vol 43 (3) ◽  
Author(s):  
Hyewon Kim ◽  
Yuwon Kim ◽  
Woojae Myung ◽  
Maurizio Fava ◽  
David Mischoulon ◽  
...  
Keyword(s):  
Suicide Attempt ◽  
Medical Records ◽  
Suicide Attempts ◽  
Case Series ◽  
Population Based ◽  
Additional Increase ◽  
Series Design ◽  
Increased Risk ◽  
Before And After ◽  
Rate Ratios

Abstract Objectives To investigate the association between zolpidem prescription and suicide attempts in people with depression Methods A nationwide, population-based electronic medical records database from the Health Insurance Review & Assessment Service of South was used to investigate the incidence rate ratios (IRRs) of suicide attempts and probable suicide attempts in people with depression before and after zolpidem prescription using self-controlled case series design. Results In a total of 445 people who attempted suicide and 23 141 people who attempted probable suicide attempt, the IRRs of suicidal behavior during the risk periods before and after zolpidem prescription increased compared with those at the baseline. The IRRs gradually increased and peaked immediately before the prescription of zolpidem. The IRR was 70.06 (95% CI: 25.58–191.90) on day 2 before zolpidem prescription and 63.35 (95% CI: 22.99–174.59) on day 1 after zolpidem prescription in the suicide attempt group. The IRR was 24.07 (95% CI: 20.50–28.26) on the day before zolpidem prescription and 14.96 (95% CI: 12.21–18.34) on the day after zolpidem prescription in the probable suicide attempt group. The ratios declined eventually after zolpidem was prescribed. Conclusions Although zolpidem prescription was associated with an increased risk of suicide attempts in people with depression, the risk increased and peaked immediately before zolpidem prescription. The risk declined gradually thereafter. This result indicates that the risk of suicide attempts increases at the time of zolpidem prescription. However, zolpidem prescription does not contribute to additional increase in the risk of suicide attempts.

Who are the suicide reattempters?

2016 ◽  
Vol 33 (S1) ◽  
pp. S600-S600
Author(s):  
E. Gattoni ◽  
C. Gramaglia ◽  
C. Delicato ◽  
S. Di Marco ◽  
I. Coppola ◽  
...  
Keyword(s):  
Risk Factors ◽  
Personality Disorder ◽  
Suicide Attempt ◽  
Emergency Room ◽  
Suicide Attempts ◽  
Somatoform Disorder ◽  
Psychiatric Disease ◽  
Psychiatric Evaluation ◽  
Axis I ◽  
Competing Interest

BackgroundHistory of previous suicide attempts is one of the most important risk factors for a subsequent completed suicide. Suicide reattempters (SR) has been long associated with demographic and clinical risk factors for suicide, such as unemployment and psychiatric disorders, however a recent review of the literature has not supported a specific age and gender profile of SR, but rather underscored that, as far as diagnosis is concerned, SR were more likely to have a personality disorder. According to literature, 16%–34% of the subjects repeat a suicide attempt within the first 2 years after the previous one.AimThe purpose of our study was evaluating clinical and socio-demographic characteristics and the outcome of psychiatric consultation among subjects referring to an emergency room for recommitting a suicide attempt.MethodsWe considered a sample of SR aged > 16 years. We extracted data from the database including all patients requiring psychiatric evaluation in the emergency room, and eventually compared the features of SR and patients with a single suicide attempt. For each patient, we gathered socio-demographic features, psychiatric history and current clinical issues, suicidal intent and suicidal behaviors.ResultsData collection and statistical analyses are still ongoing. Preliminary results show that, compared to patients with a single suicide attempt, SR were more frequent female, unmarried, employed, with a low level of instruction; they had a psychiatric disease (axis I – anxiety disorder, somatoform disorder; axis II – histrionic personality disorder); they are under the care of mental health services and under psychopharmacological treatment.Disclosure of interestThe authors have not supplied their declaration of competing interest.

scholarly journals Suicidal Career in Severe Depression among Long-Term Survivors: In a Followup after 37–53 Years Suicide Attempts Appeared to End Long before Depression

2013 ◽  
Vol 2013 ◽  
pp. 1-6 ◽  
Author(s):  
Lisa Crona ◽  
Alexander Mossberg ◽  
Louise Brådvik
Keyword(s):  
Suicide Attempt ◽  
Depressive Episode ◽  
Medical Records ◽  
Attempted Suicide ◽  
Suicide Attempts ◽  
Healing Process ◽  
Severe Depression ◽  
Long Term Survivors ◽  
Course Of Depression

Objective. To describe the suicidal career in the long-term course of severe depression.Subjects and Method. Seventy-five former in-patients were interviewed by telephone about course of depression and suicide attempts 37–53 years after index admission. Medical records were read in many cases.Results. 29 subjects had attempted suicide, 13 repeated, 10 made severe, and 13 violent attempts. The risk of suicide attempt decreased by 10% for every decade spent depressed. Suicide attempts were made early in course of depression, and more time was spent depressed after suicide attempts than before.Conclusions. A healing process of the suicidal career, which may occur long before the end of the last depressive episode (sometimes decades), is proposed.

scholarly journals Positive Predictive Value of ICD-10-CM Definitions for Adolescent Intentional Self-Harm: An Emergency Department Medical Record Review

2020 ◽  
Author(s):  
Anna Hansen ◽  
Dessi Slavova ◽  
Gena Cooper ◽  
Jaryd Zummer ◽  
Julia F Costich
Keyword(s):  
Emergency Department ◽  
Suicide Attempt ◽  
Positive Predictive Value ◽  
Medical Record ◽  
Predictive Value ◽  
Suicide Attempts ◽  
Pediatric Population ◽  
Icd 10 ◽  
Self Harm ◽  
Coding Guidelines

Abstract Background Non-suicidal self-injury and suicide attempts are increasing problems among American adolescents. This study proposed a definition for identifying intentional self-harm injuries (ISHIs) in emergency department (ED) records coded with International Classification of Diseases, 10th Revision, Clinical Modification (ICD-10-CM) codes and sought to estimate: (1) the definition’s positive predictive value (PPV) in a pediatric population treated in one Kentucky ED, and (2) the proportion of Intentional self-harm injuries (ISHIs) with intent to die (i.e., suicide attempt) that cannot be captured by ICD-10-CM codes and can only be identified by a medical record abstraction. Methods The study definition captured initial encounters for ISHIs based on first valid external cause-of-injury self-harm codes in the ICD-10-CM range X71-X83, T14.91, T36-T65, or T71. Medical records for a random sample of 207 ED discharge records were reviewed following a specified protocol. The PPV for the study definition was reported with its 95% confidence interval (95%CI). Results The estimated PPV for the study definition’s ability to capture true ISHIs was 88.9%, 95%CI (83.8%, 92.8%). The estimated percentage of ISHIs with intent to die was 45.9%, 95%CI (47.1%, 61.0%). The ICD-10-CM code “suicide attempt” (T14.91) captured only 7 cases, but coding guidelines allow assignment of this code only when the mechanism of the suicide attempt is unknown. Conclusions This study demonstrated a critical shortcoming in U.S. morbidity surveillance. The ICD-10-CM coding system and coding guidelines do not allow accurate identification of ISHIs with intent to die; modifications are needed to address this issue.

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