Citation

Ballard ED, Cwik M, Storr CL, Goldstein M, Eaton WW, Wilcox HC. Gen. Hosp. Psychiatry 2014; 36(4): 437-441.

Copyright

(Copyright © 2014, Elsevier Publishing)

DOI

10.1016/j.genhosppsych.2014.03.004

PMID

unavailable

Abstract

OBJECTIVES: Suicide is a leading cause of death; unfortunately most individuals at risk for suicide are not identified, assessed or treated by the mental health system. Investigating medical healthcare utilization among individuals with a history of suicide attempt may identify alternative settings for case finding and brief intervention.

METHODS: The study sample (n= 1422, 58% female, 72% African-American) is from a prospective cohort of adults (27-31 years) who participated in a randomized trial of school-based interventions. Logistic regression evaluated the relationship between lifetime history of suicide attempt with past year medical service utilization and selected self- reported health conditions, controlling for lifetime Major Depressive Disorder (MDD), demographic factors, health insurance status and employment.

RESULTS: A suicide attempt history was associated with past year emergency department medical visits [aOR 1.51, 95% CI 1.04-2.18, P=.03], but not primary care visits or inpatient hospitalization, when controlling for MDD and other covariates. Severe headaches and chronic gastrointestinal conditions were also associated with lifetime suicide attempt [aOR 1.50, 95% CI 1.03-2.17 and aOR 1.67, 95% CI 1.06-2.63, respectively].

CONCLUSIONS: Suicide prevention, including universal screening and brief intervention, is indicated in emergency department settings. Restricting screening to subgroups, such as those individuals presenting with depression, may miss at-risk individuals with somatic concerns. © 2014 Elsevier Inc.

Language: en

Keywords

Humans; United States; Adult; Female; Male; adult; human; Depression; Suicide; female; male; Gastrointestinal Diseases; Suicide, Attempted; Headache; Emergency Service, Hospital; suicide attempt; major depression; hospitalization; Emergency department; disease severity; article; major clinical study; controlled study; disease association; self report; headache; chronic disease; lifespan; health insurance; intervention study; emergency health service; primary health care; case finding; health care utilization; gastrointestinal disease; Depressive Disorder, Major; employment status; medical history; statistics and numerical data; utilization; Baltimore