Citation

Duică L, Pîrlog M, Antonescu E, Pop A, Scripcaru C. Rom. J. Leg. Med. 2020; 28(3): 263-268.

Copyright

(Copyright © 2020, Romanian Legal Medicine Society)

DOI

10.4323/rjlm.2020.263

PMID

unavailable

Abstract

Suicide is a major health problem, and the global suicide mortality rate amounts to 1.4% of all deaths worldwide. Personal history of suicide attempts is an important risk factor for suicide. We analyze the association between self-harm acts and suicide exploring the socio-demographics, clinical factors and other characteristics of people doing self-harm. Material and methods. We extracted from the records the different variables from all three medical services: Emergency Department (ED), the Emergency Psychiatric Service (PES) and from registered suicide deaths in the Department of Legal Medicine (DLM) in Sibiu in the period 2006-2016.

RESULTS and discussion. The socio-demographic profile of our sample shows that a bit more male patients than female patients with suicide attempts, the ratio male/female patients is 1.05 at ED and 1.32 at PES. The distribution of age pointed out the following hierarchy of the age media: 50.37 (DLM), 40.19 (PES), 36.60 (ED). In a period of ten years were approximately 40 self-harm acts for every suicide death suicide. Suicide attempts are related with many psychiatric diagnostics, the most frequent associations are Depressive Episode (34.6%), Substance related disorders (22.5%) and Adjustment disorders (17.5%). Suicide attempts are more pronounced than among young people increasing with age, thus age becoming a predictor. There is a statistically significant link between the type of unit and the emergency diagnosis. Thus, most patients diagnosed with drug ingestion end up in the ED (459), and in psychiatry and DML most patients (308 and 223, respectively) end up following a mechanical asphyxia by hanging. Most patients (114) who were diagnosed with emergency mechanical asphyxia by hanging were hospitalized with a diagnosis of depressive episode.

CONCLUSIONS. Statistically significant results show that patients come to the ED mostly for drug overdose, while in the PES come predominantly for self harm by hanging. Self-harm by hanging can be corroborate in a significant statistically relation with depressive episode. Self-harm behavior isn't a predictor for suicide (28 suicides coming from 1115 self-harm acts), but age is a predictor for the risk both for self harming and suicide. Research on the suicide risk factors in the emergency departments can contribute to predict and prevent suicide death. © 2020 Romanian Society of Legal Medicine.

Language: en

Keywords

human; homicide; suicide; Suicide; female; male; bipolar disorder; psychiatry; depression; prevalence; Suicide attempt; mortality; hospitalization; Emergency department; risk factor; major clinical study; questionnaire; prescription; personality disorder; automutilation; mental health service; intensive care unit; drug dependence; adjustment disorder; Article; atrial fibrillation; Psychiatric emergency service; Department of legal medicine; field hospital