Research Scientist, Suicide Studies Research Unit and the Li Ka Shing Knowledge Institute, St Michael's Hospital, Toronto, Ontario; Associate Professor, Department of Psychiatry, Faculty of Medicine, University of Toronto, Toronto, Ontario; Associate Professor, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario; Adjunct Scientist, Institute for Clinical Evaluative Sciences, Toronto, Ontario.
Analyst, Institute for Clinical Evaluative Sciences, Toronto, Ontario.
Can J Psychiatry. 2014 Oct;59(10):556-60. doi: 10.1177/070674371405901009.
To determine whether emergency department (ED) presentations for suicide-related behaviours (SRBs) in boys and girls were identified as more clinically acute in the ED in the period after the regulatory warnings against prescribing antidepressants and during the global economic recession, and to characterize the medical severity of SRBs among boys and girls to aid surveillance activities.
Among Ontario boys and girls (aged 12 to 17 years) presenting to the ED with an incident (index) ED SRB event between fiscal years (FYs) 2002 to 2010, we compared the number of high (compared with lower) acuity events in FYs 2005 to 2010 to those in FYs 2002 to 2004. We described the SRB method by its acuity and tested the linearity of varying trends in the SRB method in boys and girls.
In both boys and girls, high acuity events were 50% greater after FY 2004 than before, regardless of subsequent admission, and most common among boys and girls who self-poisoned. In girls, opposing linear trends before and after FY 2004 were observed in the proportion of self-poisonings and cut (or) pierce SRB methods. Throughout the study period, there was a linear decline in the proportion of boys presenting to the ED with other methods.
The previously reported increase in hospital admissions after the warnings and during the recession is unlikely artifactual. An equivalent increase in high acuity events was also evident among those not subsequently admitted. The reasons for varying responses in boys and girls by SRB method warrant further study.
确定在监管部门发布禁止开处抗抑郁药的警示以及全球经济衰退期间，男孩和女孩因自杀相关行为（SRB）而到急诊就诊的情况，是否被认为在急诊更具临床紧迫性，并描述男孩和女孩 SRB 的医疗严重程度，以辅助监测活动。
在安大略省 12 至 17 岁的男孩和女孩中，我们比较了 2005 年至 2010 年财政年度（FY）与 2002 年至 2004 年 FY 之间急诊出现的首发（索引）急诊 SRB 事件中高（与低） acuity 事件的数量。我们通过其严重程度来描述 SRB 方法，并检验男孩和女孩 SRB 方法中不同趋势的线性关系。
在男孩和女孩中，FY2004 后高 acuity 事件比之前增加了 50%，无论随后是否住院，且最常见于自伤的男孩和女孩中。在女孩中，FY2004 前后观察到自伤和割伤（或）穿刺 SRB 方法的比例呈相反的线性趋势。在整个研究期间，男孩因其他方法到急诊就诊的比例呈线性下降。
之前报道的警示后和衰退期间住院人数增加不太可能是人为的。同样，在未随后住院的人群中，高 acuity 事件也明显增加。男孩和女孩因 SRB 方法而出现不同反应的原因值得进一步研究。
