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Journal Article

Citation

Waseem M, Diaz-Guerrero RJ, Cosme R, Ain Y, Leber M, Gerber LM. Pediatr. Int. 2014; 57(3): 381-384.

Affiliation

Department of Emergency Medicine, Lincoln Medical & Mental Health Center, 234 East 149th Street, Bronx, New York10451, 718-579-6010, 718-579-4822 *fax.

Copyright

(Copyright © 2014, Japan Pediatric Society, Publisher John Wiley and Sons)

DOI

10.1111/ped.12527

PMID

25330120

Abstract

BACKGROUND: In most physicians' minds, suicidal ideation carries with it an ominous prognosis requiring intensive evaluation and treatment. We evaluated the hypothesis by first defining what an intensive psychiatric intervention would be, then determining what percentage of suicidal children received this intervention.

OBJECTIVES: To determine the proportion of children identified with suicide ideation, who received a significant psychiatric intervention.

METHODS: Medical records were reviewed for psychiatric interventions of all children presenting to the Emergency Department (ED) with behavioral disorders between 2004 and 2007, for which a psychiatry consultation was obtained. Suicidal children were those who had expressed suicidal ideation. We defined a significant psychiatric intervention as one of the following: hospitalization in a psychiatric facility, a period of observation in the ED (>12 hours), use of restraints, and prescribing a psychiatric medication. Suicidal labeling was considered "appropriate" if one or more of the above interventions were recommended by a psychiatrist. The presence of psychiatric intervention was compared with children who presented with a behavioral disorder, not labeled as suicidal. Chi-square or Fisher's Exact Test, whenever appropriate, was used to evaluate the association between suicide status and interventions.

RESULTS: We identified 160 (27.1%) children who were labeled suicidal and 431 (72.9%) children with a behavioral disorder, who were classified as non-suicidal. 244/431 (56.6%) in the non-suicidal group had a significant psychiatric intervention compared to 79/160 (49.4%) of children with suicidal ideation (P=0.116). This 49.4% is significantly different from an a priori assumption that 100% of children with suicidal ideation would have a significant psychiatric intervention.

CONCLUSION: Over half (50.6%) of the children presenting with a label of suicidal ideation did not receive significant psychiatric intervention. This study calls into question the accuracy of suicide labeling in children referred to the ED.


Language: en

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