1 School of Social and Community Medicine, University of Bristol, Bristol, UK.
2 Avon and Wiltshire Mental Health Partnership NHS Trust, UK.
Crisis. 2018 Nov;39(6):469-478. doi: 10.1027/0227-5910/a000522. Epub 2018 May 31.
The rise in Internet use adds a new dimension to suicide prevention. We investigated suicide/self-harm (S/Sh)-related Internet use among patients presenting to hospital with self-harm.
We asked 1,198 adult and 315 child and adolescent patients presenting to hospital following self-harm in a city in South West England about Internet use associated with their hospital presentation. Associations between Internet use and sociodemographic and clinical characteristics were investigated using multivariable logistic regression models. Focus groups with clinicians explored the acceptability and utility of asking about Internet use.
The prevalence of S/Sh-related Internet use was 8.4% (95% CI: 6.8-10.1%) among adult hospital presentations and 26.0% (95% CI = 21.3-31.2%) among children's hospital presentations. In both samples, S/Sh-related Internet use was associated with higher levels of suicidal intent. Mostly, clinicians found it acceptable to ask about Internet use during psychosocial assessments and believed this could inform perceptions of risk and decision-making.
It is unclear whether the findings in this study are applicable to the general self-harm patient population because only those who had psychosocial assessments were included.
S/Sh-related Internet use is likely to become increasingly relevant as the Internet-native generation matures. Furthermore, Internet use may be a proxy marker for intent.
互联网使用的增加为预防自杀增添了新的维度。我们调查了因自残而到医院就诊的患者与自杀/自残(S/Sh)相关的互联网使用情况。
我们询问了在英格兰西南部一个城市因自残而到医院就诊的 1198 名成年患者和 315 名儿童和青少年患者与他们就诊相关的互联网使用情况。使用多变量逻辑回归模型调查了互联网使用与社会人口统计学和临床特征之间的关联。与临床医生进行焦点小组讨论,探讨了询问互联网使用情况的可接受性和实用性。
在成年患者就诊中,S/Sh 相关互联网使用的患病率为 8.4%(95%CI:6.8-10.1%),在儿童患者就诊中为 26.0%(95%CI=21.3-31.2%)。在这两个样本中,S/Sh 相关互联网使用与更高的自杀意图水平相关。大多数临床医生发现,在心理社会评估期间询问互联网使用情况是可以接受的,并且认为这可以帮助了解风险感知和决策。
由于仅纳入了接受心理社会评估的患者,因此尚不清楚本研究中的发现是否适用于一般的自残患者人群。
随着互联网原生代的成熟,S/Sh 相关互联网使用可能会变得越来越重要。此外,互联网使用可能是意图的替代标记。