Abstract


 Objective: In the adolescence period, suicide attempts by drug overdose is the problem that emergency doctors are often faced with. It is very important to identify risk factors that can be predictive of future suicide attempts. In our study, we evaluated the adolescents who presented to our pediatric department with suicidal drug overdose to assess the risk factors clinically and demographically. 

Material and Methods: The records of 135 patients (10-18 years of age) who presented to our pediatric emergency department with suicidal drug overdose were evaluated during a one-year period (1.10.2015 and 1.10.2016). 






Results: We included 135 patients (82.2% female) with an average age of 15.65±1.37 years in the study. Most of the patients were in the middle adolescence (14-16 years) period (69.6%). 17 patients (12.6%) had a prior suicide attempt history. The time between drug overdose and arrival at the pediatric emergency department was 4.2 hours (min. 1 hour-max. 96 hours) on average. 72.6% of the them applied in the first 4 hours. 60 patients had taken multiple drugs. The usage frequency of the drugs (single/multiple) that the patients had taken to commit suicide was analgesics 48.9%, antidepressants 28.9%, antibiotics 20.7%, gastrointestinal drugs 14%, antihypertensive 8.8%, antipsychotics 7.4%, antiepileptics 7.4% and others (antidiabetics, vitamins-minerals, decongestants, muscle relaxants, antihistamines, psychostimulants, antithrombotics, antigut drugs) 14.8%. The reasons for suicide attempts included family related reasons, boy-girl friend separation, exam anxiety, school anxiety and others (loneliness, gender dysphoria). The most frequent psychiatric disorders that had been previously diagnosed were major depressive disorder, conduct disorder and attention deficit hyperactivity disorder. Epilepsy had been diagnosed in 3 patients other than psychiatric disorder. The number of suicide attempts with the drugs started for these diagnoses (n=22, %16.3) was statistically significant (p<0.05). All the patients were hospitalized and observed for at least 24 hours. There was no mortality during or after the suicide attempt. 

Conclusion: Clinicians working with young people are required to assess the presence of suicidal ideation, suicidal behavior, and other risk factors, and to determine the level of risk. 

Keywords: Adolescence, Drug overdose

References

  1. 1. Karaman D, Durukan İ. Çocuk ve ergenlerde özkıyım. Psikiyatride
  2. Güncel Yaklaşımlar 2013;5:30-47.
  3. 2. Shain B. Committee on adolescence. Suicide and suicide attempts
  4. in adolescents. Pediatrics 2016;138, pii: e20161420.
  5. 3. Heron M. Deaths among adolescents aged 15–19 years. National
  6. Vital Statistics Reports. Vol: 66, No.5, November 27, 2017 https://
  7. www.cdc.gov/nchs/fastats/adolescent-health.htm
  8. 4. Türkiye İstatistik Kurumu, İntihar istatistikleri-2015, www.tuik.gov.
  9. tr/PreHaberBultenleri.do?id=21516
  10. 5. Gümüş B, Özer B, Yıldırım A, Çetin İ. Türkiye İstatistik Kurumu
  11. verilerine göre Türkiye’de intihar olgularının değerlendirilmesi. Adli
  12. Tıp Bülteni 2010;15:104-9.
  13. 6. Tatar G, Ulucay T, Asirdizer M, Yavuz M S, Zeyfeoglu Y, Dalgic M ve
  14. ark. İzmir (Türkiye)’de ergen ve gençlerde mediko-legal ölümlerin
  15. analizi. Ege Tıp Dergisi 2014;53:25-32.
  16. 7. Nock MK, Green JG, Hwang I, McLaughlin KA, Sampson NA,
  17. Zaslavsky AM, et al. Prevalence, correlates, and treatment of
  18. lifetime suicidal behavior among adolescents: Results from the
  19. national comorbidity survey replication adolescent supplement.
  20. JAMA Psychiatry 2013;70:300-10.
  21. 8. Şimşek H, Donmez G, Binbay T, Erkoyun E, Uçku R. Manisa
  22. İli’nde özkıyım girişimlerine ilişkin özellikler: Beş yıllık verinin
  23. değerlendirilmesi. Turk J Public Health 2014;12:23-34.
  24. 9. Eaton DK, Kann L, Kinchen S, Shanklin S, Ross J, Hawkins J,
  25. et al. Youth risk behavior surveillance-United States 2009. MMWR
  26. Surveill Summ 2010;59:1-142.
  27. 10. Schwartz KA, Pyle SA, Dowd MD, Sheehan K. Attitudes and
  28. beliefs of adolescents and parents regarding adolescent suicide.
  29. Pediatrics 2010;125:221-7.
  30. 11. Perou R, Bitsko RH, Blumberg SJ, Pastor P, Ghandour RM,
  31. Gfroerer JC et al. Mental health surveillance among children-United
  32. States, 2005-2011. Centers for Disease Control and Prevention
  33. (CDC) Suppl 2013;62:1-35.
  34. 12. Akkaya-Kalayci T, Popow C, Winkler D, Bingöl RH, Demir T, Özlü
  35. Z. The impact of migration and culture on suicide attempts of
  36. children and adolescents living in Istanbul. Int J Psychiatry Clin
  37. Pract 2015;19:32-9.
  38. 13. Borowsky IW, Ireland M, Resnick MD. Adolescent suicide attempts:
  39. Risks and protectors. Pediatrics 2001;107:485-93.
  40. 14. Hawton K, Saunders KE, O’connor RC. Self-harm and suicide in
  41. adolescents. Lancet 2012;379:2373-80.
  42. 15. Koplin B, Agathen J. Suicidality in children and adolescents: A
  43. review. Curr Opin Pediatr 2002;14:713-51.
  44. 16. Manceaux P, Jacques D, Zdanowicz N. Hormonal and
  45. developmental influences on adolescent suicide: A systematic
  46. review. Psychiatr Danub 2015;27:S300-4.
  47. 17. Gibbons RD, Brown CH, Hur K, Davis J, Mann JJ. Suicidal
  48. thoughts and behavior with antidepressant treatment: Reanalysis
  49. of the randomized placebo-controlled studies of fluoxetine and
  50. venlafaxine. Arch Gen Psychiatry 2012;69:580-7.
  51. 18. Akdemir D, Zeki A, Ünal D, Kara M, Çuhadaroğlu Çetin F. Kendine
  52. zarar verme davranışı olan ergenlerde psikiyatrik belirtiler, kimlik
  53. karmaşası ve benlik saygısı. Anadolu Psikiyatri Derg 2013;14:69-
  54. 76.
  55. 19. Aktepe E, Kandil S, Topbaş M. Çocuk ve ergenlerde özkıyım
  56. davranışı. TSK Koruyucu Hekimlik Bülteni 2005;4:88-97.
  57. 20. Yalaki Z, Taşar MA, Yalçın Dallar Y. Çocukluk ve gençlik dönemindeki
  58. özkıyım girişimlerinin değerlendirilmesi. Ege Journal of Medicine
  59. 2011;50:125-8.
  60. 21. Gökdemir MT, Kaya H, Erdoğan MÖ, Söğüt Ö, Tanırcan MZ,
  61. Büyükaslan H ve ark. Özkıyım girişimi nedeni ile acil servise başvuru:
  62. Erken ve geç ergenlerin klinik özellikleri. JAEM 2013;12:185-8.
  63. 22. Doğan H, Adıgüzel L, Uysal E, Sarıkaya S, Özüçelik DN, Okuturlar
  64. Y ve ark. Öz kıyım amaçlı adölesan ve erişkin ilaç zehirlenmeleri
  65. arasındaki farklılıklar. Bakırköy Tıp Dergisi 2016;12:20-3.
  66. 23. Arat C, Türkmenoğlu Y, Akşahin BG, Yılmaz B, Sarıtaş Ü, Hamilçıkan
  67. B ve ark. Çocuk acil servisimize zehirlenme ile başvuran özkıyım
  68. olgularının değerlendirilmesi. Van Med J 2016;23:7-12.
  69. 24. Keskinoğlu A, İnan F. İlaç veya toksik madde alımı ile gerçekleşen
  70. ergen yaş özkıyım girişimlerinde böbrek fonksiyonlarının
  71. değerlendirilmesi. Haseki Tıp Bülteni 2012;50:96-100.
  72. 25. Gündüz RC, Halil H, Doğanay Özgüven Y, Gürsoy C, Karagöl
  73. C, Çiftci A ve ark. Adölesanlardaki intihar girişimlerinin profili;
  74. demografik özellikler, nedenler ve risk faktörleri. Türkiye Çocuk
  75. Hast Derg 2016;3:177-81.
  76. 26. Öner Ö, Ergüder T, Çakır B, Ergun U, Erşahin Y, Erol N, ve ark.
  77. Ergenlerin bildirdiği dürtüsellik belirtileri ve ruhsal sorunlar:
  78. Epidemiyolojik bir çalışma. Türk Psikiyatri Dergisi 2013;24:35-43.
  79. 27. Ougrin D, Tranah T, Stahl D, Moran P, Asarnow JR. Therapeutic
  80. interventions for suicide attempts and self-harm in adolescents:
  81. Systematic review and meta-analysis. J Am Acad Child Adolesc
  82. Psychiatry 2015;54:97-107.
  83. 28. Asarnow JR, Berk M, Hughes JL, Anderson NL. The SAFETY
  84. program: A treatment-development trial of a cognitive-behavioral
  85. family treatment for adolescent suicide attempters. J Clin Child
  86. Adolesc Psychol 2015;44:194-203.
  87. 29. Hawton K, Witt KG, Taylor Salisbury TL, Arensman E, Gunnell
  88. D, et al. Interventions for self-harm in children and adolescents.
  89. Cochrane Database Syst Rev 2015;21:CD012013.
  90. 30. Suicide Prevention Resource Center Evidence Based Practices.
  91. Best practices registry 2011; http://www2.sprc. org/bpr/index.
  92. 31. Wyman PA, Brown CH, Inman J, Cross W, Schmeelk-Cone K,
  93. Guo J, et al. Randomized trial of a gatekeeper program for suicide
  94. prevention: 1-year impact on secondary school staff. J Consult Clin
  95. Psychol 2008;76:104-15.

How to cite

1.
Öden Akman A. Evaluation of Suicide Attempts by Drug Overdose in the Adolescent Age Group. Turk J Pediatr Dis [Internet]. 2019 Mar. 21 [cited 2025 May 25];13(1):7-12. Available from: https://turkjpediatrdis.org/article/view/633