Department of Psychiatry, 71545Sunnybrook Health Science Centre, University of Toronto, Toronto, ON, Canada.
Division of Psychiatry, 156647Imperial College London Hammersmith Hospital Campus, London, United Kingdom.
Can J Psychiatry. 2022 Aug;67(8):598-607. doi: 10.1177/07067437211058602. Epub 2021 Nov 30.
To evaluate the clinical features of Canadian adolescents admitted to the intensive care unit (ICU) for medically serious self-harm.
2700 Canadian paediatricians were surveyed monthly over two years (January 2017 to December 2018) through the to ascertain data from eligible cases.
Ninety-three cases (73 female; age 15.2 ± 1.5) met the case definition. Four provinces reported the majority of cases: Quebec (n = 27), Ontario (n = 26), Alberta (n = 21), and British Columbia (n = 8). There were 10 deaths, 9 by hanging. Overdose and hanging were the most frequently reported methods of self-harm (74.2% and 19.4%, respectively). Overdose was more common in females (80.8% females vs. 50% males; χ = 7.8 (1), = .005), whereas hanging was more common in males (35% males vs. 15.1% females, χ = 3.9 (1), = .04). More females than males had a past psychiatric diagnosis (79% vs. 58%; χ = 4.1 (1), = .06), a previous suicide attempt (55.9% vs. 29.4%, χ = 3.8 (1), = .05), and prior use of mental health service (69.7% vs. 27.8%, χ = 10.4 (1), = .001). Family conflict was the most commonly identified precipitating factor (43%) of self-harm.
Among Canadian adolescents admitted to the ICU with medically serious self-harm, females demonstrate a higher rate of suicide attempts and prior mental health care engagement, whereas males are more likely to die by suicide. These findings are consistent with data from other adolescent samples, as well as data from working-age and older adults. Therefore, a sex-specific approach to suicide prevention is warranted as part of a national suicide prevention strategy; family conflict may be a specific target for suicide prevention interventions among adolescents.
评估因医学原因严重自残而入住加拿大重症监护病房（ICU）的青少年的临床特征。
通过 每月对 2700 名加拿大儿科医生进行调查，为期两年（2017 年 1 月至 2018 年 12 月），以确定符合条件病例的数据。
93 例（73 例女性；年龄 15.2±1.5）符合病例定义。有四个省报告了大多数病例：魁北克（n=27）、安大略省（n=26）、艾伯塔省（n=21）和不列颠哥伦比亚省（n=8）。有 10 例死亡，其中 9 例为上吊自杀。药物过量和上吊自杀是最常报告的自残方式（分别为 74.2%和 19.4%）。女性药物过量的比例更高（80.8%的女性与 50%的男性；χ2=7.8（1），=0.005），而男性上吊自杀的比例更高（35%的男性与 15.1%的女性，χ2=3.9（1），=0.04）。与男性相比，更多女性有既往精神科诊断（79%比 58%；χ2=4.1（1），=0.06）、既往自杀未遂（55.9%比 29.4%，χ2=3.8（1），=0.05）和既往使用精神卫生服务（69.7%比 27.8%，χ2=10.4（1），=0.001）。家庭冲突是最常见的自残诱发因素（43%）。
在因医学原因严重自残而入住加拿大 ICU 的青少年中，女性自杀未遂和既往精神卫生保健就诊的比例更高，而男性自杀的可能性更高。这些发现与其他青少年样本以及成年和老年人群的数据一致。因此，需要采取有针对性的性别措施来预防自杀，这是国家预防自杀战略的一部分；家庭冲突可能是青少年自杀预防干预的特定目标。
