Kemal Samaa, Krass Polina, Brogan Leah, Min Jungwon, Quarshie William O, Fein Joel A
Division of Emergency Medicine, Department of Pediatrics, Ann & Robert H. Lurie Children's Hospital of Chicago (S Kemal), Chicago, Ill; Division of Emergency Medicine, Department of Pediatrics, Children's Hospital of Philadelphia (S Kemal, P Krass, and JA Fein), Philadelphia, Pa.
Division of Emergency Medicine, Department of Pediatrics, Children's Hospital of Philadelphia (S Kemal, P Krass, and JA Fein), Philadelphia, Pa; Center for Violence Prevention, Children's Hospital of Philadelphia (P Krass, L Brogan, and JA Fein), Philadelphia, Pa; PolicyLab, Children's Hospital of Philadelphia (P Krass), Philadelphia, Pa; National Clinician Scholars Program, University of Pennsylvania (P Krass), Philadelphia, Pa.
Acad Pediatr. 2023 Jan-Feb;23(1):165-171. doi: 10.1016/j.acap.2022.05.011. Epub 2022 May 15.
This study compares current suicidal ideation, prior suicide attempt and associated self-reported risk factors in adolescents with and without access to firearms.
Using data from a clinically applied behavioral health assessment completed by adolescents presenting to a tertiary children's hospital emergency department (ED; N = 15,806), we evaluated the association between firearm access (ie, firearm in the home or ability to obtain one within 24 hours), each of the included suicide risk factors (ie, depressive symptoms, trauma victimization, bullying victimization), and our primary outcomes (ie, current suicidal ideation and prior suicide attempt). We performed regression analyses on 3 groups: 1) The overall population; 2) Only the participants with firearm access; and 3) Only the participants without firearm access.
Fourteen percent (2179/15,806) of the sample reported a firearm in the home or ability to access one within 24 hours. Overall, 6.8% of participants reported current suicidal ideation and 9.1% reported prior suicide attempt. Youth with firearm access had 1.52 times higher odds of current suicidal ideation and 1.61 times higher odds of prior suicide attempt compared to youth without firearm access. All included suicide risk factors were found to significantly increase the odds of current suicidal ideation and prior suicide attempt in the overall sample; this increase was similar in the groups with and without firearm access.
Adolescents with firearm access have higher odds of suicidal ideation and prior attempt compared to those without firearm access, highlighting the need for universal ED-based screening for suicidality and lethal means.
本研究比较了有机会接触枪支和没有机会接触枪支的青少年当前的自杀意念、既往自杀未遂情况及相关的自我报告风险因素。
利用一家三级儿童医院急诊科（ED；N = 15806）就诊的青少年完成的临床应用行为健康评估数据，我们评估了枪支接触情况（即家中有枪支或能在24小时内获取枪支）、所纳入的各自杀风险因素（即抑郁症状、受创伤经历、受欺凌经历）与我们的主要结局（即当前自杀意念和既往自杀未遂）之间的关联。我们对三组进行了回归分析：1）总体人群；2）仅接触枪支的参与者；3）仅未接触枪支的参与者。
样本中有14%（2179/15806）报告家中有枪支或能在24小时内获取枪支。总体而言，6.8%的参与者报告有当前自杀意念，9.1%的参与者报告有既往自杀未遂。与未接触枪支的青少年相比，接触枪支的青少年当前有自杀意念的几率高1.52倍，既往有自杀未遂的几率高1.61倍。在总体样本中，所有纳入的自杀风险因素均显著增加了当前自杀意念和既往自杀未遂的几率；在接触枪支和未接触枪支的组中，这种增加情况相似。
与未接触枪支的青少年相比，接触枪支的青少年有更高的自杀意念和既往自杀未遂几率，这凸显了在急诊科对自杀倾向和致命手段进行普遍筛查的必要性。
