Division of Child and Adolescent Psychiatry, Department of Psychiatry, Severance Hospital, Institute of Behavioral Science in Medicine, Yonsei University College of Medicine, Seoul, Korea.
Yonsei Med J. 2020 Jul;61(7):614-622. doi: 10.3349/ymj.2020.61.7.614.
Emergency department (ED) is a common treatment setting for adolescents with clinically serious self-harm. Here, we investigated the clinical characteristics and trends of adolescents with self-harm who visited the ED in one Korean university hospital. We also compared patients with a single ED visit to those with multiple ED visits to identify the risk factor of repeated visits.
We retrospectively identified patients aged 12 to 18 years who presented to ED for self-harm from January 2015 to December 2019, based on electronic medical records. Self-harm included all thoughts and behaviors indicating intents to harm or hurt oneself, regardless of the degree of such attempt.
A total of 168 individuals (male:female=31:137; average 15.99±1.64 years) presented to ED following 304 episodes (45 and 259 episodes in males and females, respectively). The number of episodes steeply increased between 2016 and 2019, and the overall number during the study showed an increasing trend (=0.043). Repeated ED visitors with self-harm showed more history of psychiatric treatment/admission (58.3% vs. 85.4%, =0.002; 14.2% vs. 43.9%, <0.001), history of child abuse (32.3% vs. 53.7%, =0.013), and familial psychiatric history (13.4% vs. 31.7%, =0.008) compared to those with a single visit.
Among Korean adolescents, the number of ED visits and repetition of ED visits for self-harm is on the rise. For adolescents presenting to ED with self-harm, the history of psychiatric treatment/admission, child abuse, and familial psychiatric history should be properly obtained to identify the risk for multiple ED visits.
急诊科(ED)是青少年临床严重自伤的常见治疗场所。在这里,我们调查了在一家韩国大学医院急诊科就诊的自伤青少年的临床特征和趋势。我们还比较了单次 ED 就诊和多次 ED 就诊的患者,以确定再次就诊的风险因素。
我们根据电子病历,回顾性地确定了 2015 年 1 月至 2019 年 12 月期间因自伤就诊 ED 的 12 至 18 岁患者。自伤包括所有表示有意伤害或伤害自己的想法和行为,无论此类尝试的程度如何。
共有 168 人(男:女=31:137;平均年龄 15.99±1.64 岁)因 304 次发作(男性和女性分别为 45 次和 259 次)就诊 ED。发作次数在 2016 年至 2019 年间急剧增加,研究期间的总数呈上升趋势(=0.043)。有多次 ED 就诊自伤史的患者既往精神科治疗/住院(58.3% vs. 85.4%,=0.002;14.2% vs. 43.9%,<0.001)、儿童虐待史(32.3% vs. 53.7%,=0.013)和家族精神病史(13.4% vs. 31.7%,=0.008)较单次就诊者更多。
在韩国青少年中,ED 就诊次数和自伤重复就诊次数呈上升趋势。对于因自伤就诊 ED 的青少年,应适当获取精神科治疗/住院、儿童虐待和家族精神病史,以确定多次 ED 就诊的风险。