Parkland Health & Hospital System, Dallas, TX; Department of Psychiatry, The University of Texas Southwestern Medical Center, Dallas, TX.
Office of the Clinical Director, National Institute of Mental Health, National Institutes of Health, Bethesda, MD.
J Acad Consult Liaison Psychiatry. 2021 Jul-Aug;62(4):421-429. doi: 10.1016/j.jaclp.2020.12.002. Epub 2021 Mar 9.
Suicidal behavior is increasing among US youths. Contact with the health care system is common in the months before suicide.
To assess the characteristics of suicide risk among youths presenting for health care, universal screening results from a large hospital system were analyzed.
A retrospective analysis of the Ask Suicide-Screening Questions tool administered to patients aged 10-17 years in a hospital system including an emergency department, inpatient medical units, and primary care clinics was conducted. Demographic and clinical data from 3 years of encounters were analyzed.
The sample consisted of 91,580 pediatric encounters, predominantly white Hispanic and women, with one third speaking Spanish. Across health care settings, 2.9% of encounters produced positive suicide risk screens, with the highest rate in the emergency department (8.5%). Acute positive screens, indicating imminent risk for suicidal behavior, accounted for 0.3% of all encounters. Approximately one-fourth (27.6%) of encounters for psychiatric presenting problems screened positive compared with 2.3% for nonpsychiatric encounters. Higher rates of positive screens were present among encounters for psychiatric presenting problems across all settings. Positive screens were less common among preteen (1.8%) than adolescent (3.1%) encounters (χ = 65.50, P < 0.001).
Universal screening detected suicide risk in approximately 3% of pediatric health care encounters. Screening identified risk in encounters among preteen and adolescent patients, with a higher prevalence of positive screens in encounters for youths presenting with psychiatric problems and for emergency department visits. Acute positive screens were rare, occurring in less than half of 1 percent of encounters.
自杀行为在美国青少年中呈上升趋势。自杀前的几个月，他们经常与医疗保健系统接触。
分析美国某大型医院系统进行普遍筛查后的结果，评估青少年因自杀风险到医疗保健机构就诊的特征。
对该医院系统（包括急诊部、住院医疗单位和初级保健诊所）中 10-17 岁患者使用自杀筛查问题工具（Ask Suicide-Screening Questions tool）的情况进行回顾性分析。分析了 3 年就诊中患者的人口统计学和临床数据。
该样本包括 91580 例儿科就诊，主要为白西班牙裔和女性，其中三分之一的人讲西班牙语。在所有医疗保健环境中，有 2.9%的就诊产生了阳性自杀风险筛查结果，其中急诊部的阳性率最高（8.5%）。急性阳性筛查结果表明自杀行为的即时风险，占所有就诊的 0.3%。大约四分之一（27.6%）的精神科就诊存在阳性筛查结果，而非精神科就诊的阳性率为 2.3%。在所有环境中，精神科就诊的阳性筛查率都更高。在所有年龄段的就诊中，阳性筛查结果在青少年（3.1%）中比在儿童（1.8%）中更常见（χ²=65.50，P <0.001）。
普遍筛查在大约 3%的儿科保健就诊中发现了自杀风险。筛查发现了青少年和儿童就诊中存在风险，其中有精神科就诊问题和急诊就诊的青少年就诊中阳性筛查结果的发生率更高。急性阳性筛查结果罕见，不到所有就诊的一半。
