The characteristics of serious suicide attempters in Japanese adolescents- comparison study between adolescents and adults

BMC Psychiatry

Yoshiro Okubo¹  Takuya Saito¹  Ryuichiro Narishige¹  Takao Ito¹  Yoshitaka Kawashima¹ 

[1] Department of Neuropsychiatry, Nippon Medical School, 1-1-5, Sendagi, Bunkyo-ku, Tokyo, 113-8602, Japan

关键词: Critical care medicine;    Age differences;    Adolescents;    Suicide attempts;   

Others  :  1124241
DOI  :  10.1186/1471-244X-12-191

 received in 2012-04-21, accepted in 2012-10-02,  发布年份 2012

【 摘 要 】

Background

Suicide is the leading cause of death among Japanese adolescents, and they may commit suicide differently from adults. However, there are few studies in medical-based data concerning adolescent patients seriously attempting suicide. We aimed to explore the characteristics of serious suicide attempts in Japanese adolescents, comparing them with those in adults.

Methods

We investigated adolescents who seriously attempted suicide and were treated at the Critical Care Medical Center (CCMC) of Nippon Medical School Hospital between 2000 and 2010, and we compared them with adult suicide attempters treated during 2009. We retrospectively studied medical records and collected clinical data and socio-demographic factors, including age, sex, psychiatric symptoms or diagnosis, methods of suicide attempt, motives for suicide attempt, previous deliberate self-harm, previous psychiatric history, parent loss experience, and previous psychiatric history in the family.

Results

Adolescent attempters were 15 males and 44 females, 13 to 18 years old (mean 16.39). Adult attempters were 37 males and 65 females, 19 to 79 years old (mean 39.45). In comparison to adult attempters, adolescent attempters were more frequently diagnosed with Borderline Personality Disorder (BPD), had more school problems and parent loss experience, but they had less financial problems. Gender differences between adolescents and adults were examined, and male adolescent attempters were found to be more frequently diagnosed with schizophrenia and had less financial problems than their adult counterparts, while female adolescent attempters were more frequently diagnosed with BPD, had more school problems and parent loss, but they had less previous psychiatric history than their adult counterparts.

Conclusions

Our findings indicated that adolescent attempters were more frequently diagnosed with BPD and had more school problems and parent loss experience but had less financial problems. Additionally, in male adolescent attempters, identifying patients with schizophrenia seemed important, as it was their most frequent psychiatric diagnosis. For female adolescents, adequately assessing family function and interpersonal conflicts seemed important, as they were more often diagnosed with BPD and had more school and family problems.

【 授权许可】

   
2012 Kawashima et al.; licensee BioMed Central Ltd.

【 参考文献 】

• [1]National Police Agency: Statistics of suicide victims in Japan in 2004. National Police Agency Japan 2005. in Japanese
• [2]World Health Organization: Country reports and charts available. http://www.who.int/mental_health/prevention/suicide/country_reports/en/index.html webcite
• [3]National Police Agency: Statistics of suicide victims in Japan in 2010. National Police Agency Japan 2011. in Japanese)
• [4]Ministry of Health, Labour and Welfare: Vital statistics of Japan 2010. http://www.mhlw.go.jp/toukei/saikin/hw/jinkou/geppo/nengai10/dl/h22_gaikyou.pdf webcite
• [5]Desapriya EB, Iwase N: New trends in suicide in Japan. Inj Prev 2003, 9(3):284.
• [6]Bridge JA, Goldstein TR, Brent DA: Adolescent suicide and suicidal behavior. J Child Psychol Psychiatry 2006, 47(3–4):372-394.
• [7]Hidaka Y, Operario D, Takenaka M, et al.: Attempt suicide and associated risk factors among youth in urban Japan. Soc Psychiatry Psychiatr Epidemiol 2008, 43(9):752-757.
• [8]Katsumata Y, Matsumoto T, Kitani M, et al.: Electronic media use and suicidal ideation in Japanese adolescents. Psychiatry Clin Neurosci 2008, 62(6):744-746.
• [9]Matsumoto T, Imamura F, Chiba Y, et al.: Prevalences of lifetime histories of self-cutting and suicidal ideation in Japanese adolescents: differences by age. Psychiatry Clin Neurosci 2008, 62(3):362-364.
• [10]Haukka J, Suominen K, Partonen T: Determinants and outcomes of serious attempted suicide: a nationwide study in Finland, 1996–2003. Am J Epidemiol 2008, 167(10):1155-1163.
• [11]Hischfeld RM, Russell JM: Assessment and treatment of suicidal patients. N Engl J Med 1997, 337(13):910-915.
• [12]Tidemalm D, Langstrom N, Lichtenstein P: Risk of suicide after suicide attempt according to coexisting psychiatric disorder: Swedish cohort study with long term follow-up. BMJ 2008, 337:a2205.
• [13]Dube SR, Anda RF, Felitti VJ, et al.: Childhood abuse, household dysfunction, and the risk of attempted suicide throughout the life span: findings from the Adverse Childhood Experiences Study. JAMA 2001, 286(24):3089-3096.
• [14]Qin P, Agerbo E, Mortensen PB: Suicide risk in relation to family history of completed suicide and psychiatric disorders: a nested case–control study based on longitudinal registers. Lancet 2002, 360(9340):1126-1130.
• [15]Beautrais A: Subsequent mortality in medically serious suicide attempts: a 5 year follow-up. Aust N Z J Psychiatry 2003, 37(5):595-599.
• [16]Nordstrom P, Samuelson M, Asberg M: Survival analysis of suicide risk after attempted suicide. Acta Psychiatr Scand 1995, 91(5):336-340.
• [17]Owens D, Horrocks J, House A: Fatal and non fatal repetition of self-harm. Systematic review. Br J Psychiatry 2002, 181:193-199.
• [18]Spirito A, Brown L, Overholser J, et al.: Attempted suicide in adolescence: A review and critique of the literature. Clin Psychol Rev 1989, 9(3):335-363.
• [19]Shaffer D, Piacentini J: Suicide and attempted suicide. In Child psychiatry: Modern approaches. 3rd edition. Edited by Rutter M, Taylor E. Oxford: Blackwell Scientific; 1994:407-424.
• [20]Beautrais A: Suicide and serious suicide attempts in youth: a multiple-group comparison study. Am J Psychiatry 2003, 160(6):1093-1099.
• [21]Lewis M: Dulcan MK. In Textbook of Child and Adolescent Psychiatry. 3rd edition. Edited by Wiener JM. America: American Psychiatric Publishing; 2003:13-44.
• [22]Kerr D, Preuss L, King C: Suicidal adolescents’ social support from family and peer: gender-specific associations with psychopathology. J Abnorm Child Psychol 2006, 34(1):103-114.
• [23]Daniel S, Goldston D: Interventions for suicidal youth: a review of the literature and developmental considerations. Suicide Life Threat Behav 2009, 39(3):252-268.
• [24]Weisz J, Hawley K: Developmental factors in the treatment of adolescents. J Consult Clin Psychol 2002, 70(1):21-43.
• [25]Kurosawa H, Iwasaki Y, Watanabe N, et al.: The practice of consultation-liaison psychiatry in Japan. Gen Hosp Psychiatry 1993, 15(3):160-165.
• [26]Kishi Y, Iwasaki Y, Takezawa K, et al.: Delirium in critical care unit patients admitted through an emergency room. Gen Hosp Psychiatry 1995, 17(5):371-379.
• [27]Nock MK, Borges G, Bromet EJ, et al.: Suicide and suicidal behavior. Epidemiol Rev 2008, 30:133-154.
• [28]Posner K, Oquendo MA, Gould M: Columbia Classification Algorithm of Suicide Assessment (C-CASA): classification of suicidal events in the FDA’s pediatric suicidal risk analysis of antidepressants. Am J Psychiatry 2007, 164(7):1035-1043.
• [29]Gould MS, Greenberg T, Velting DM, et al.: Youth suicide risk and preventive interventions: a review of the past 10 years. J Am Acad Child Adolesc Psychiatry 2003, 42(4):386-405.
• [30]Yamada T, Kawanishi C, Hasegawa H, et al.: Psychiatric assessment of suicide attempters in Japan: a pilot study at a critical emergency unit in an urban area. BMC Psychiatry 2007, 7:64-70. BioMed Central Full Text
• [31]Takahashi S, Matsuura M, Tanabe E, et al.: Age at onset of schizophrenia: gender differences and influence of temporal socioeconomic change. Psychiatry Clin Neurosci 2000, 54(2):153-156.
• [32]Breier A, Astrachan BM: Characterization of schizophrenic patients who commit suicide. Am J Psychiatry 1984, 141(2):206-209.
• [33]Palmer BA, Pankratz VS, Bostwick JK: The lifetime risk of suicide in schizophrenia: a reexamination. Arch Gen Psychiatry 2005, 62(3):247-253.
• [34]Joa I, Johannessen JO, Langeveld J, et al.: Baseline profiles of adolescent vs. adult-onset first-episode psychosis in an early detection program. Acta Psychiatr Scand 2009, 119(6):494-500.
• [35]Melle L, Johannessen JO, Friis S, et al.: Course and predictors of suicidality over the first two years of treatment in first-episode schizophrenia spectrum psychosis. Arch Suicide Res 2010, 14(2):158-170.
• [36]Marttunen MJ, Henriksson MM, Aro HM, et al.: Suicide among female adolescents: characteristics and comparison with males in the age group 13 to 22 years. J Am Acad Child Adolesc Psychiatry 1995, 34(10):1297-1307.
• [37]Runeson B, Beskow J: Borderline personality disorder in young Swedish suicides. J Nerv Ment Dis 1991, 179(3):153-156.
• [38]Nurmi JE: How do adolescents see their future? A review of the development of future orientation and planning. Dev Rev 1991, 11(1):1-59.
• [39]Reyna V, Farley F: Risk and rationality in adolescent decision making: implications for theory, practice, and public policy. Psychological Science in the Public Interest 2006, 7(1):1-44.
• [40]Inoue K, Tanii H, Abe S, et al.: The report in the correlation between the factor of unemployment and suicide in Japan. Am J Forensic Med Pathol 2008, 29(2):202-203.