Recent medical service utilization and health conditions associated with a history of suicide attempts

Elizabeth D. Ballard, Mary Cwik, Carla L. Storr, Mitchell A Goldstein, William W Eaton, Holly Wilcox

Research output: Contribution to journalArticle

Abstract

Objectives: Suicide is a leading cause of death; unfortunately most individuals at risk for suicide are not identified, assessed or treated by the mental health system. Investigating medical healthcare utilization among individuals with a history of suicide attempt may identify alternative settings for case finding and brief intervention. Methods: The study sample (n= 1422, 58% female, 72% African-American) is from a prospective cohort of adults (27-31 years) who participated in a randomized trial of school-based interventions. Logistic regression evaluated the relationship between lifetime history of suicide attempt with past year medical service utilization and selected self- reported health conditions, controlling for lifetime Major Depressive Disorder (MDD), demographic factors, health insurance status and employment. Results: A suicide attempt history was associated with past year emergency department medical visits [aOR 1.51, 95% CI 1.04-2.18, P= .03], but not primary care visits or inpatient hospitalization, when controlling for MDD and other covariates. Severe headaches and chronic gastrointestinal conditions were also associated with lifetime suicide attempt [aOR 1.50, 95% CI 1.03-2.17 and aOR 1.67, 95% CI 1.06-2.63, respectively]. Conclusions: Suicide prevention, including universal screening and brief intervention, is indicated in emergency department settings. Restricting screening to subgroups, such as those individuals presenting with depression, may miss at-risk individuals with somatic concerns.

Original languageEnglish (US)
Pages (from-to)437-441
Number of pages5
JournalGeneral Hospital Psychiatry
Volume36
Issue number4
DOIs
StatePublished - 2014

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Keywords

  • Depression
  • Emergency department
  • Suicide

ASJC Scopus subject areas

  • Psychiatry and Mental health
  • Medicine(all)

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