National Study of US Emergency Department Visits for Attempted Suicide and Self-Inflicted Injury, 1997-2001
Received 3 November 2004; received in revised form 15 March 2005; accepted 14 April 2005. published online 18 August 2005.
Study objective
We describe the epidemiology of emergency department (ED) visits for attempted suicide and self-inflicted injury.
Methods
Data were obtained from the National Hospital Ambulatory Medical Care Survey, a national probability sample of ED visits. All visits for attempted suicide or self-inflicted injury (E950 to E959) during 1997 to 2001 were included in these analyses.
Results
During the 5-year period, there were approximately 412,000 annual ED visits for attempted suicide and self-inflicted injury, or 0.4% of all ED visits. The annual visit rate was 1.5 (1.3 to 1.7) visits per 1,000 US citizens. The mean patient age was 31 years, and visits were most common among patients aged 15 to 19 years, at a rate of 3.3 (95% confidence interval 2.1 to 4.4). ED visit rates were higher among female patients (1.7) than male patients (1.3) and among blacks (1.9) than whites (1.5). Visit rates did not differ by metropolitan status or US region. The most common method of injury was poisoning (68%), followed by cutting or piercing (20%). One third of visiting patients were admitted to the hospital, with 31% of admissions going to the ICU. A psychiatric disorder was coded for 55% of visits, with depressive disorder accounting for 34% and alcohol abuse for 16%.
Conclusion
ED visits for attempted suicide and self-inflicted injury are relatively common, serious, and most frequent among adolescents and young adults. Self-poisoning is the most common method. The high prevalence of psychiatric and substance abuse disorders in this population suggests these issues should be considered during management and disposition.
From the University of Michigan Medical School, Ann Arbor, MI (Doshi); Departments of Emergency Medicine and Psychiatry, Cooper Hospital and University of Medicine and Dentistry of New Jersey–Robert Wood Johnson Medical School, Camden, NJ (Boudreaux); and the Department of Emergency Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA (Doshi, Wang, Pelletier, Camargo)
Address for reprints: Carlos A. Camargo, Jr, MD, DrPH, EMNet Coordinating Center, Department of Emergency Medicine, Massachusetts General Hospital, 326 Cambridge Street, Suite 410, Boston, MA 02114; 617-726-5276, fax 617-724-4050
Supervising editor: Arthur L. Kellermann, MD, MPH
Author Contributions: AD, EDB, NW, AJP, and CAC conceived the study, planned the data analytic strategy, interpreted the results, and drafted/edited the manuscript. AJP and CAC conducted the data analyses. CAC takes responsibility for the paper as a whole.
Funding and support: Dr. Camargo was supported, in part, by an EMF Center of Excellence Award (Dallas, TX) and Dr. Boudreaux by grant DA-16698 from the National Institutes of Health (Bethesda, MD).
ABSTRACT