Sheridan David C, Hendrickson Robert G, Lin Amber L, Fu Rongwei, Horowitz B Zane
Department of Emergency Medicine, Oregon Health & Science University, Portland, Oregon.
Department of Emergency Medicine, Oregon Health & Science University, Portland, Oregon; Oregon Poison Center, Portland, Oregon.
J Adolesc Health. 2017 Feb;60(2):191-195. doi: 10.1016/j.jadohealth.2016.09.012. Epub 2016 Nov 23.
Suicide attempts by adolescents most commonly involve the overdose of medications. To date, there has been little information on the over-the-counter or prescription medicines that adolescents ingest for self-harm. Identification of medications chosen in suicide attempts may help guide anticipatory guidance to parents by primary care providers and Poison Centers in prevention programs.
This was a retrospective observational study using the American Association of Poison Control Center's National Poison Data System. Data were collected on patients aged 13-19 years old at the time of their substance ingestion, between the years 2004 and 2013 and that were coded as reason for ingestion of "intentional-suspected suicide."
During the 10-year study period, there were 390,560 poison center calls for intentional-suspected suicide in the United States between 2004 and 2013, accounting for 80.3% of all "intentional" ingestion calls in the adolescent population. Over the entire age range, the most common substance ingested included acetaminophen (10.9%), ibuprofen (9%), selective serotonin reuptake inhibitors (7.7%), atypical antipsychotic (6%), and antihistamines (5%). The most common medications coded as resulting in major clinical effects or death were antidepressants and atypical antipsychotics.
Adolescent ingestion choices for suicide attempts have remained relatively consistent over the past 10 years. However, there was a recent decrease in selective serotonin reuptake inhibitor ingestions. The most common medications used in an overdose attempt were ibuprofen and acetaminophen. Further preventative efforts are needed in this at-risk population from multiple providers at various levels.
青少年自杀未遂最常见的方式是过量服药。迄今为止，关于青少年用于自我伤害而摄入的非处方药或处方药的信息很少。确定自杀未遂时所选用的药物，可能有助于初级保健提供者和预防项目中的中毒控制中心为家长提供预期指导。
这是一项回顾性观察研究，使用了美国中毒控制中心协会的国家中毒数据系统。收集了2004年至2013年间物质摄入时年龄在13至19岁之间、且被编码为摄入原因是“故意——疑似自杀”的患者的数据。
在为期10年的研究期间，2004年至2013年间美国中毒控制中心接到390,560次关于故意——疑似自杀的电话，占青少年人群所有“故意”摄入电话的80.3%。在整个年龄范围内，最常摄入的物质包括对乙酰氨基酚（10.9%）、布洛芬（9%）、选择性5-羟色胺再摄取抑制剂（7.7%）、非典型抗精神病药物（6%）和抗组胺药（5%）。被编码为导致主要临床影响或死亡的最常见药物是抗抑郁药和非典型抗精神病药物。
在过去10年中，青少年自杀未遂时的摄入选择相对保持一致。然而，最近选择性5-羟色胺再摄取抑制剂的摄入量有所下降。过量服药未遂时最常用的药物是布洛芬和对乙酰氨基酚。需要各级多个提供者对这一高危人群进一步开展预防工作。
