Increasing Trend and Characteristics of Korean Adolescents Presenting to Emergency Department for Self-Harm: A 5-Year Experience, 2015 to 2019

Abstract

Purpose: Emergency department (ED) is a common treatment setting for adolescents with clinically serious self-harm. Here, we investigated the clinical characteristics and trends of adolescents with self-harm who visited the ED in one Korean university hospital. We also compared patients with a single ED visit to those with multiple ED visits to identify the risk factor of repeated visits. Materials and Methods: We retrospectively identified patients aged 12 to 18 years who presented to ED for self-harm from January 2015 to December 2019, based on electronic medical records. Self-harm included all thoughts and behaviors indicating intents to harm or hurt oneself, regardless of the degree of such attempt. Results: A total of 168 individuals (male:female=31:137; average 15.99±1.64 years) presented to ED following 304 episodes (45 and 259 episodes in males and females, respectively). The number of episodes steeply increased between 2016 and 2019, and the overall number during the study showed an increasing trend (p=0.043). Repeated ED visitors with self-harm showed more history of psychiatric treatment/admission (58.3% vs. 85.4%, p=0.002; 14.2% vs. 43.9%, p<0.001), history of child abuse (32.3% vs. 53.7%, p=0.013), and familial psychiatric history (13.4% vs. 31.7%, p=0.008) compared to those with a single visit. Conclusion: Among Korean adolescents, the number of ED visits and repetition of ED visits for self-harm is on the rise. For adolescents presenting to ED with self-harm, the history of psychiatric treatment/admission, child abuse, and familial psychiatric history should be properly obtained to identify the risk for multiple ED visits.

Suicide attempt-related emergency department visits among adolescents: a nationwide population-based study in Korea, 2016–2019

“…In this study, we found that the incidence rates of SA-related ED visits was increasing in female adolescents from 2016 to 2019. This finding is consistent with results reported in previous studies conducted in Korea about the increase in number of female teenagers engaging in suicidal behaviors, including SA as well as suicidal ideation and suicidal planning [ 6 , 29 ]. The increase in SAs among female seems to contribute to the stagnation of the suicide rate despite the introduction of suicide prevention programs in Korea.…”

Non‐suicidal self‐injury is associated with psychotic like experiences, depression, and bullying in Korean adolescents

“…Suicide is the leading cause of death among South Korean adolescents. A recent Korean study regarding adolescents who visited an emergency department after self‐harm found that the number of episodes increased greatly between 2015 and 2019 (Cheon et al, 2020). Although research interest in NSSI has grown rapidly, few studies have explored NSSI in Korean adolescents (Kim & Yu, 2017).…”

Trends in Depressive Symptoms and Suicidality of South Korean Adolescents: Comparison of Expected and Observed Prevalence During the COVID-19 Pandemic

“…The results from the current study are partly consistent with the previous studies showing that the elevated severity of mental health symptoms in the early stages of the pandemic (March–April) decreased in mid-2020 and was recovered to the pre-pandemic level, which is an indication of psychological resilience [ 15 ]. According to previous studies using data of emergency department visits resulting from suicide attempts among Korean adolescents, suicide attempts in Korean adolescents increased between 2015 and 2019 [ 30 ], whereas in 2020, the overall trend of suicide attempts did not change significantly from before the pandemic [ 31 ]. Improved mental health outcomes among adolescents were also observed in other Asian countries during the pandemic and lockdown [ [32] , [33] , [34] , [35] ].…”