From the Division of Emergency Medicine, Cooper University Hospital, Camden, NJ.
Center for Family Intervention Science, College of Nursing and Health Professions, Drexel University.
Pediatr Emerg Care. 2022 Feb 1;38(2):e595-e599. doi: 10.1097/PEC.0000000000002453.
This study evaluates the relationship between substance use and impairment and current suicidal thoughts or behaviors in adolescent patients screened in a pediatric emergency department (ED).
Data were collected between June 2013 and February 2018 from adolescent patients who presented to a single, urban, pediatric ED. Adolescents completed a computerized, self-administered assessment that evaluates depression, suicide, posttraumatic stress, violence, traumatic exposure, bullying, and substance use. Assessments are administered as standard care to all ED patients aged 14 to 18 years. We used binary logistic regression to estimate the odds of reporting current suicidal thoughts or behaviors associated with patient demographics (ie, age, sex, and race), substance use in the past month, and substance-related impairment.
A total of 11,623 adolescent patients (65.4% female and 52.9% African American) completed the assessment. Participants were, on average, 15.7 years old (SD = 1.27). Younger age (odds ratio [OR], 0.79; 95% confidence interval [CI], 0.74-0.84) and substance use impairment (OR, 0.44; 95% CI, 0.33-0.58) decreased the odds of reporting current suicidal thoughts or behaviors, whereas male sex (OR, 1.51; 95% CI, 1.28-1.79) and those with past-month substance use (OR, 1.85; 95% CI, 1.51-2.26) increased the odds.
Recent substance use and male sex are associated with a higher likelihood of adolescents reporting current suicidal thoughts or behaviors during an ED visit. Standardized screening during pediatric ED visits may allow for more efficient evaluation of patients in higher-risk groups.
本研究评估了在儿科急诊部（ED）筛查的青少年患者中物质使用与障碍和当前自杀想法或行为之间的关系。
数据收集于 2013 年 6 月至 2018 年 2 月期间，来自于一位城市儿科 ED 的青少年患者。青少年患者完成了一项计算机化的自我评估，评估内容包括抑郁、自杀、创伤后应激、暴力、创伤暴露、欺凌和物质使用。这些评估是作为对所有 14 至 18 岁 ED 患者的标准护理进行的。我们使用二项逻辑回归来估计报告当前自杀想法或行为的可能性，这些可能性与患者人口统计学特征（即年龄、性别和种族）、过去一个月的物质使用以及与物质相关的障碍有关。
共有 11623 名青少年患者（65.4%为女性，52.9%为非裔美国人）完成了评估。参与者的平均年龄为 15.7 岁（SD=1.27）。年龄较小（比值比[OR]，0.79；95%置信区间[CI]，0.74-0.84）和物质使用障碍（OR，0.44；95% CI，0.33-0.58）降低了报告当前自杀想法或行为的可能性，而男性（OR，1.51；95% CI，1.28-1.79）和过去一个月物质使用（OR，1.85；95% CI，1.51-2.26）增加了这种可能性。
最近的物质使用和男性性别与青少年在 ED 就诊期间报告当前自杀想法或行为的可能性增加有关。在儿科 ED 就诊期间进行标准化筛查可能允许对高风险群体中的患者进行更有效的评估。
