Retrospective evaluation of children and adolescents hospitalized in the pediatric intensive care unit of OUR hospital DUE to suicide attempts

Introduction and Objectives: Although suicide is not common in childhood, it is a public health problem that is increasing in frequency in adolescence. The basis of suicidal behavior is the thought of harming oneself. Various risk factors leading to suicide have been categorized as predisposing and triggering factors; Predisposing factors include presence of psychiatric illness, previous suicide attempt, family history of mood disorder or suicidal behavior, sexual or physical abuse, exposure to violence and biological factors, while triggering factors are access to tools, substance use, social stress and isolation, emotional and cognitive factors. Pediatricians play a primary role in researching and recognizing these risk factors and communicating with other specialties to prevent and treat suicidal behavior. The American Academy of Pediatrics (AAP) recommends annual suicide screening in adolescents during visits and routine check-ups for acute illnesses. In our study, we aimed to determine the sociodemographic characteristics, factors leading to suicide, suicide methods and preventive approaches of patients who attempted suicide in the pediatric and adolescent age group between January 2019 and January 2022 and were followed up in the Pediatric Intensive Care Unit of Tekirdağ Namık Kemal University Hospital. Materials and Methods: Our study included 45 patients aged 10-18 years who attempted suicide between January 2019 and January 2022 and were hospitalized in the Pediatric Intensive Care Unit of Tekirdağ Namık Kemal University Medical Faculty Hospital. Pediatric patients who were hospitalized in the Pediatric Intensive Care Unit due to accidental medication were not included in the study. In our study, the patients were retrospectively analyzed for sociodemographic characteristics, characteristics of suicide attempt, previous history of psychiatric illness in themselves or in their families, psychopathology conditions determined by the Department of Child Psychiatry and Diseases after the intervention, chronic disease states, previous attempts, number of previous attempts, the presence of non-suicidal self-injury behavior, the presence of stressor factors leading to suicide, psychosocial risk factors, whether they were followed by the Department of Child Psychiatry before or after the intervention, and the relationships between these factors were examined. Results: A total of 45 cases with a mean age of 15.31±1.61 years, aged between 10 and 18, were included in our study. 13.3% (n=6) of the cases were male and 86.7% (n=39) were female. Statistically significant difference was not found between age and gender distributions, educational status/continuity, chronic disease history, season of the attempt, previous suicide attempt, NSSI history, psychiatric disease history, psychopathology status, post-intervention psychiatric control status, family history of psychiatric disease, previous referral to psychiatry and continuation of the treatment given (p>0.05). A statistically significant correlation was found between previous suicide attempt and psychiatric disease history and previous referral to psychiatry (p=0.002; p=0.001; p<0.01, respectively). On the other hand, no statistically significant correlation was found between psychopathology status and previous suicide attempt (p>0.05). A statistically significant relationship was found between non-suicidal self-injury behaviour and psychiatric disease history, psychopathology status, previous admission to psychiatry, and psychiatric control after suicide attempt (respectively p=0.03; p=0.032; p<0.05; p=0.001; p=0.009; p<0.01). No statistically significant correlation was found between continuing the previous treatment, family history of psychiatric illness, and non-suicidal self-injury,ehaviour (p>0.05). Conclusions: Suicide remains a serious cause of death worldwide. Not all suicides are preventable, but a methodical approach to suicide risk assessment can enable healthcare providers to manage patients at risk of suicide. Comprehensive risk assessment is one of the primary duties of a Child Health and Diseases specialist, especially considering the increased incidence of suicide in adolescence. Keywords: Suicide, Suicide Attempt, Non-Suicidal Self-Injury