Suicidality and hospitalization as cause and outcome of pediatric psychiatric emergency room visits.

The aim of this study was to identify predictors of suicidality in youth presenting to a pediatric psychiatric emergency room service (PPERS). To this end, we conducted a retrospective cohort study of youth aged <18 years consecutively assessed by a PPERS 01.01.2002-12.31.2002, using a 12-page semi-...

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Publicado en:European Child & Adolescent Psychiatry Vol. 24; no. 7; pp. 797 - 815
Autores principales: Grudnikoff, Eugene, Soto, Erin, Frederickson, Anne, Birnbaum, Michael, Saito, Ema, Dicker, Robert, Kane, John, Correll, Christoph
Formato: research tables/charts Journal Article
Publicado: Springer Nature Jul2015
Acceso en línea:Ver este registro en EBSCOhost
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      dt: Jul2015
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      pub: Springer Nature
      place: New York, New York
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        atl: Suicidality and hospitalization as cause and outcome of pediatric psychiatric emergency room visits.
      aug:
        au:
          Grudnikoff, Eugene
          Soto, Erin
          Frederickson, Anne
          Birnbaum, Michael
          Saito, Ema
          Dicker, Robert
          Kane, John
          Correll, Christoph
        affil: Zucker Hillside Hospital, North Shore-Long Island Jewish Health System, 75-59 263rd Street Glen Oaks 11004 USA
      sug:
        subj:
          Suicidal Ideation
          Hospitalization
          Pediatric Care
          Emergency Services, Psychiatric
          Human
          Retrospective Design
          Multiple Logistic Regression
          Descriptive Statistics
          Male
          Female
          Sex Factors
          Scales
          Depression
          Adolescence
          Child
          Child, Preschool
          Post Hoc Analysis
          New York
          Algorithms
          Analysis of Variance
          Chi Square Test
          Odds Ratio
          Confidence Intervals
          Adolescent: 13-18 years
          Child: 6-12 years
          Child, Preschool: 2-5 years
          Male
          Female
      ab: The aim of this study was to identify predictors of suicidality in youth presenting to a pediatric psychiatric emergency room service (PPERS). To this end, we conducted a retrospective cohort study of youth aged <18 years consecutively assessed by a PPERS 01.01.2002-12.31.2002, using a 12-page semi-structured institutional evaluation form and the Columbia Classification Algorithm for Suicide Assessment. Multivariate regression analyses were conducted to identify correlates of suicidal thoughts and attempts/preparation and their relationship to outpatient/inpatient disposition. Of 1,062 youth, 265 (25.0 %) presented with suicidal ideation (16.2 %) or attempt/preparation (8.8 %). Suicidal ideation was associated with female sex, depression, adjustment disorder, absent referral by family/friend/self, school referral, precipitant of peer conflict, and no antipsychotic treatment ( p < 0.0001). Suicidal attempt/preparation was associated with female sex, depression, lower GAF score, past suicide attempt, precipitant of peer conflict, and no stimulant treatment ( p < 0.0001). Compared to suicidal attempt/preparation, suicidal ideation was associated with school referral, and higher GAF score ( p < 0.0001). Of the 265 patients with suicidality, 58.5 % were discharged home (ideation = 72.1 % vs. attempt/preparation = 33.7 %, p < 0.0001). In patients with suicidal ideation, outpatient disposition was associated with higher GAF score, school referral, and adjustment disorder ( p < 0.0001). In patients with suicidal attempt/preparation, outpatient disposition was associated with higher GAF score, lower acuity rating, and school referral ( p < 0.0001). Suicidality is common among PPERS evaluations. Higher GAF score and school referral distinguished suicidal ideation from suicidal attempt/preparation and was associated with outpatient disposition in both presentations. Increased education of referral sources and establishment of different non-PPERS evaluation systems may improve identification of non-emergent suicidal presentations and encourage more appropriate outpatient referrals.
      pubtype: Academic Journal
      doctype:
        research
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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