UMEM Educational Pearls

Category: Toxicology

Title: Trend of suicide attempt in adolescent and young adults

Keywords: suicide attempt, adolescent, young adults, epidemiological trend (PubMed Search)

Posted: 10/10/2019 by Hong Kim, MD, MPH (Updated: 11/19/2019)
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The rate of suicide attempt has been increasing over the past decade. A recently published article investigated the temporal trend of suicide attempts in adolescent/young adult population (10 – 25 years old) from 2000 to 2018.

 Methods

  • All intentional – suspected suicide cases were identified from the National Poison Data System from Jan 1, 2000 to December 31, 2018. 
  • Following age groups were compared: 10-12, 13-15, 16-18, 19-21 and 22-25 years old.

Results

  • A total of 1,677,435 cases were identified with 0.1% fatality (n=1579).
  • Female: 70.6% (n=1,184,691) 
  • Single substance (64.1%; n=1,074,423)
  • Highest suicide attempt rate: 16-18 years (30.1%; n=504,682)
  • Lowest suicide attempt rate: 10-12 years (2.3%; n=38,428)
  • The suicide attempt rate increased significantly starting 2011 in 10-12, 13-15 and 16-19 years age groups with seasonal trend
    •  Higher during school months (Sept to May) vs. non-school months (June-August)

Top 5 substance involved in suicide attempt

  1. OTC analgesics
  2. Antidepressants
  3. Sedative hypnotics
  4. Antihistamines
  5. Antipsychotics

Agents associated with serious medical outcome (after 2011)

  1. Antidepressants
  2. OTC analgesics
  3. Antihistamines 
  4. ADHD medications
  • ADHD medicaitons: common in 10-15 years population
  • Sedative hypnotics (e.g. benzodiazepines): common in older age group (16-25 years)

Conclusion

  • Rate of suicide attempt in adolescent and young adults has increase, especially since 2011.
  • The substance used in suicide attempt usually involves medications available to the specific age group.
  • OTC medications (analgesics and antihistamines) were involved in a third of the suicide attemps.

References

Spiller HA et al. Suicide attempts by self-poisoning in the United States among 10-25 year olds from 2000 to 2018: substances used, temporal changes and demographics. Clin Toxicol (Phila) 2019. Oct 6:1-12. doi: 10.1080/15563650.2019.1665182. [Epub ahead of print]