Frequent follow-up of suicidal youth assessed in the emergency room: Long-term trajectory and predictors of suicidality

Association of In-School and Electronic Bullying with Suicidality and Feelings of Hopelessness among Adolescents in the United States

BACKGROUND

Suicide-related behaviors increasingly contribute to behavioral health crises in the United States (U.S.) and worldwide. The problem was worsened during the COVID-19 pandemic, especially for youth and young adults. Existing research suggests suicide-related behaviors are a consequence of bullying, while hopelessness is a more distal consequence. This study examines the association of in-school and electronic bullying with suicide-related behavior and feelings of despair among adolescents, adjusted for sociodemographic characteristics, abuse experience, risk-taking behaviors, and physical appearance/lifestyles.

METHOD

Using Chi-square, logistic regression, and multinomial logistic regression, we analyzed the US 2019 Youth Risk Behavior Surveillance System (YRBSS) national component. The YRBSS includes federal, state, territorial, and freely associated state, tribal government, and local school-based surveys of representative sample middle and high school students in the US. The 2019 YRBSS participants comprised 13,605 students aged 12 to 18 years and roughly equal proportions of males and females (50.63% and 49.37%, respectively).

RESULTS

We observed a significant association (p < 0.05) between being bullied and depressive symptoms, and the association was more vital for youth bullied at school and electronically. Being bullied either at school or electronically was associated with suicidality, with a stronger association for youth who experienced being bullied in both settings.

CONCLUSION

Our findings shed light on assessing early signs of depression to prevent the formation of suicidality among bullied youth.

The incidence of self-harm ingestions in adolescents and young adults at a tertiary care center

BACKGROUND

There has been an increasing incidence of self-harm attempts in recent years in the United States. Particularly concerning, there has been a growing trend of self-harm in the adolescent and young adult population. In order to inform initiatives to address this trend, risk factors and substances used for self-harm need to be clarified.

METHODS

This is a descriptive retrospective observational study on all cases of self-harm poisoning in patients between the ages of 12 and 25 years reported at the state's only tertiary care center from January 2019 through March 2022.

RESULTS

There was an increased incidence of 69% for self-harm poisonings for all ages and a 90% increase in ages 12-17 years between the years 2019 and 2021. Fifty percent of all cases occurred in patients aged 14-17 years, 69% were female, and 22% required an intensive care unit. The top three most common substances used are available without a prescription.

DISCUSSION

There was a persistent increase in self-harm attempts via poisoning throughout the study period with a particularly vulnerable period in the adolescent age group.

Factors associated with a borderline personality disorder diagnosis in the emergency department

INTRODUCTION

Research on borderline personality disorder (BPD) has shown that less intensive care is especially effective when patients have been told about their condition. However, problems with diagnosing the disorder are also described in the literature. This study thus aims to explore the factors associated with the challenges of identifying and then communicating a BPD diagnosis to patients.

METHODS

We analyzed a database of 202 patients of Toulouse University Hospital (France) who had a CIM-10 F60.3 diagnosis. This data was used to identify the sociodemographic and clinical benchmarks associated with patients who had received an established BPD diagnosis prior to their attendance at the hospital's emergency department (ED) in the study period.

RESULTS

Sixty-three percentage of the patients admitted to our psychiatric ED had been given an earlier diagnosis of BPD. Those who had not been diagnosed were more likely to: not have undergone any psychiatric follow-up; not have been hospitalized in the psychiatry department; and not have previously attended at the ED. Patients with BPD and a comorbidity of MDD were also less likely to have received a BPD diagnosis before their ED admission.

CONCLUSION

This study found that patients without an established BPD diagnosis who present at the ED are more likely to not be known to the psychiatric care system. This suggests that EDs have a specific role to play in making a diagnosis and the subsequent orientation of care.