Characteristics of children and adolescents presenting to the emergency department with self-inflicted injury: Retrospective analysis of two teaching hospitals

Background: Data on Taiwanese adolescents with self-inflicted injuries are limited. We describe the epidemiology of children and adolescents visiting the emergency department for self-inflicted injuries in two geographically distinct teaching hospitals. Methods: Medical records of children 0–18 year...

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Main Authors: Tu-Hsuan Chang, Chun-Hsien Yu, Giou-Teng Yiang, Han-Yun Chang, Jun Yi Sim
Format: Article
Language:English
Published: Elsevier 2022-03-01
Series:Pediatrics and Neonatology
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Online Access:http://www.sciencedirect.com/science/article/pii/S1875957221002011
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author Tu-Hsuan Chang
Chun-Hsien Yu
Giou-Teng Yiang
Han-Yun Chang
Jun Yi Sim
author_facet Tu-Hsuan Chang
Chun-Hsien Yu
Giou-Teng Yiang
Han-Yun Chang
Jun Yi Sim
author_sort Tu-Hsuan Chang
collection DOAJ
description Background: Data on Taiwanese adolescents with self-inflicted injuries are limited. We describe the epidemiology of children and adolescents visiting the emergency department for self-inflicted injuries in two geographically distinct teaching hospitals. Methods: Medical records of children 0–18 years old who visited the emergency department of Taipei Tzu Chi Hospital and Chi Mei Medical Center, Tainan between 2016 and 2019 coded with relevant diagnoses were reviewed. Visits with documented self-inflicted injury were included. Results: During the 4-year period, 62 children made 74 emergency visits for self-inflicted injury. A total of 88% of visits were made by children with a psychiatric diagnosis, with depressive disorders being the most common (57%). Interpersonal relationship issue was cited as a trigger for self-harm in 49% of visits. Adjusted for annual visit volumes, self-harm visits per 10,000 pediatric emergency visits increased nearly 5 fold between 2016 and 2019, with the most prominent increase in the final year. Poisoning was the most common mechanism of injury and was frequently used by females, as compared to males who tended to jump from heights. Up to 96% of adolescents with previous self-harm seen at the emergency department had sought psychiatric help in the past year. Urban-rural inequity in mental health resource utilization was observed. Conclusions: Visits to the emergency department for self-inflicted injuries among children and adolescents increased, most remarkably in 2019, for both hospitals. Intentional poisoning with prescription and over-the-counter medications was the most common method. There was a high prevalence of psychiatric disorders in our study population. As the emergency department is likely the first point of medical contact for such visits, emergency personnel should be trained appropriately on managing such patients.
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spelling doaj-art-064290b8e35d438c9ff8a58aaf9ab97d2025-08-20T03:17:18ZengElsevierPediatrics and Neonatology1875-95722022-03-0163213113810.1016/j.pedneo.2021.08.014Characteristics of children and adolescents presenting to the emergency department with self-inflicted injury: Retrospective analysis of two teaching hospitalsTu-Hsuan Chang0Chun-Hsien Yu1Giou-Teng Yiang2Han-Yun Chang3Jun Yi Sim4Department of Pediatrics, Chi-Mei Medical Center, 901 Zhonghua Road, Yongkang District, Tainan City 71004, TaiwanDepartment of Pediatrics, Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, 289 Jianguo Road, Xindian District, New Taipei City 23142, Taiwan; Department of Pediatrics, Buddhist Tzu Chi University College of Medicine, Hualien, TaiwanDepartment of Emergency Medicine, Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Taiwan; Department of Emergency Medicine, Buddhist Tzu Chi University College of Medicine, Hualien, TaiwanKaohsiung Municipal Kai-Syuan Psychiatric Hospital, 130 Kai-Syuan 2nd Road, Lingya District, Kaohsiung, TaiwanDepartment of Pediatrics, Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, 289 Jianguo Road, Xindian District, New Taipei City 23142, Taiwan; Corresponding author.Background: Data on Taiwanese adolescents with self-inflicted injuries are limited. We describe the epidemiology of children and adolescents visiting the emergency department for self-inflicted injuries in two geographically distinct teaching hospitals. Methods: Medical records of children 0–18 years old who visited the emergency department of Taipei Tzu Chi Hospital and Chi Mei Medical Center, Tainan between 2016 and 2019 coded with relevant diagnoses were reviewed. Visits with documented self-inflicted injury were included. Results: During the 4-year period, 62 children made 74 emergency visits for self-inflicted injury. A total of 88% of visits were made by children with a psychiatric diagnosis, with depressive disorders being the most common (57%). Interpersonal relationship issue was cited as a trigger for self-harm in 49% of visits. Adjusted for annual visit volumes, self-harm visits per 10,000 pediatric emergency visits increased nearly 5 fold between 2016 and 2019, with the most prominent increase in the final year. Poisoning was the most common mechanism of injury and was frequently used by females, as compared to males who tended to jump from heights. Up to 96% of adolescents with previous self-harm seen at the emergency department had sought psychiatric help in the past year. Urban-rural inequity in mental health resource utilization was observed. Conclusions: Visits to the emergency department for self-inflicted injuries among children and adolescents increased, most remarkably in 2019, for both hospitals. Intentional poisoning with prescription and over-the-counter medications was the most common method. There was a high prevalence of psychiatric disorders in our study population. As the emergency department is likely the first point of medical contact for such visits, emergency personnel should be trained appropriately on managing such patients.http://www.sciencedirect.com/science/article/pii/S1875957221002011adolescentadolescent medicineemergency departmentself-injurious behaviorTaiwan
spellingShingle Tu-Hsuan Chang
Chun-Hsien Yu
Giou-Teng Yiang
Han-Yun Chang
Jun Yi Sim
Characteristics of children and adolescents presenting to the emergency department with self-inflicted injury: Retrospective analysis of two teaching hospitals
Pediatrics and Neonatology
adolescent
adolescent medicine
emergency department
self-injurious behavior
Taiwan
title Characteristics of children and adolescents presenting to the emergency department with self-inflicted injury: Retrospective analysis of two teaching hospitals
title_full Characteristics of children and adolescents presenting to the emergency department with self-inflicted injury: Retrospective analysis of two teaching hospitals
title_fullStr Characteristics of children and adolescents presenting to the emergency department with self-inflicted injury: Retrospective analysis of two teaching hospitals
title_full_unstemmed Characteristics of children and adolescents presenting to the emergency department with self-inflicted injury: Retrospective analysis of two teaching hospitals
title_short Characteristics of children and adolescents presenting to the emergency department with self-inflicted injury: Retrospective analysis of two teaching hospitals
title_sort characteristics of children and adolescents presenting to the emergency department with self inflicted injury retrospective analysis of two teaching hospitals
topic adolescent
adolescent medicine
emergency department
self-injurious behavior
Taiwan
url http://www.sciencedirect.com/science/article/pii/S1875957221002011
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