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Risk for Later Suicide Up for Certain Youth Presenting to ED

Hazard ratios significantly increased for self-directed violence after initial visit for epilepsy, seizures

MONDAY, Dec. 17, 2018 (HealthDay News) — The risk for subsequent self-directed violence is increased among young people presenting to the emergency department for certain medical conditions, according to a study published online Dec. 17 in the American Journal of Preventive Medicine.

Jing Wang, M.D., M.P.H., from the U.S. Centers for Disease Control and Prevention in Atlanta, and colleagues examined the risk for self-directed violence after visiting the emergency department among an exposure group aged 15 to 29 years with 2,192,322 emergency department visits for 16 selected conditions. The reference group included 149,163 emergency department visits for a minor infection.

The researchers found that during a six-month period, 0.4 percent of all patients visited the emergency department for self-directed violence. The hazard ratio for subsequent self-reported violence was significantly increased with initial visits for epilepsy or seizures (6.0 and 5.7, respectively). Moderately elevated risk was seen for initial visits for other conditions (hazard ratios mainly <2.0). A threefold to fivefold increase in hazard ratios was seen for second visits for various pain symptoms, syncope, vomiting, and non-self-directed violence injury. For third or later visits, hazard ratios increased to 8.8 for back pain, 6.9 for headache, and 5.0 for abdominal pain, dental complaints, and non-self-directed violence injury.

“The broad number of physical health conditions associated with an increased risk of self-directed violence may serve to support expanded or broader screening for self-directed violence risk in emergency departments,” the authors write.

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