Suicidal ideation, suicide attempts, and psychological distress among intoxicated adolescents in the pediatric emergency department

Abstract

Background: Studies have emphasized screening for psychiatric disorders, especially suicide risk in emergency departments. Psychiatric disorders and experimentation with alcohol increase in adolescence and intoxications among patients challenge the staff in emergency departments.

Aims: This study examined the degree of suicidal ideation (SI) and suicidal behavior in adolescents, and the extent to which they differed from non-suicidal patients in terms of alcohol use, psychological distress, self-esteem, and perceived social support.

Methods: The study comprised 120 adolescents, a mean age of 14.2 years. Of them 60% were females. We collected data on the clinical characteristics and assessed the patient’s psychiatric status using self-report scales and analyzed blood samples for alcohol. A consulting psychiatrist interviewed each patient before discharge to evaluate potential SI or suicide attempt (SA) using structured and semi-structured scales.

Results: Of the 120 patients 20% had SI or had made a SA. High psychological distress in girls, low blood alcohol levels (BALs), as well as low scores on self-esteem, on social support and on familial support were associated with patients with SI/SA. Logistic regression showed that the most significant variables with suicidal patients included low BAL and low self-esteem and high alcohol consumption. Psychological distress had a direct and mediational role in the suicidal patients.

Conclusions: Adolescents referred to the pediatric emergency department with intoxication displaying high psychological distress and low self-esteem represent a high-risk group of teens. In this group, careful assessment of mental health status, screening for suicidal ideation, and SAs seems warranted.

Keywords:

• Adolescents
• alcohol intoxication
• suicidal ideation
• suicide attempt
• psychological distress
• emergency department

Acknowledgments

We thank the consulting psychiatrists for their contribution to the interviews, and the medical staff at the PED of the Hospital for Children and Adolescents of Helsinki University Central Hospital for their contribution to the research and to patient recruitment. We thank research assistant Eevaliisa Orelma for her contribution to the data management.

Disclosure statement

The authors report no conflicts of interest. The authors alone are responsible for the content and the writing of the article.