Healthcare utilization, psychiatric disorders, and physical illnesses shortly before suicide mortality in adolescents in Taiwan

This study examined the pattern of medical utilization and the distribution of comorbidities shortly before death among adolescents who died from suicide and compared these data with those of living controls. From Taiwan's National Health Insurance Research Database, this study identified adole...

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Bibliographic Details
Published in:	Psychological medicine 2023-05, Vol.53 (7), p.2885-2894
Main Authors:	Lee, Wan-Chen, Lai, Jou-Yin, Pan, Chun-Hung, Su, Sheng-Siang, Yang, Tien-Wei, Tsai, Shang-Ying, Chen, Chiao-Chicy, Kuo, Chian-Jue
Format:	Article
Language:	eng
Subjects:	Adolescent Adolescents Autopsies Cardiovascular diseases Case-Control Studies Certification Codes Comorbidity Drug overdose Emergency medical care Health care Health care policy Health services utilization Heart diseases Humans Mental disorders Mental Disorders - epidemiology Mental Disorders - psychology Mental health care Mortality National health insurance Original Article Patient Acceptance of Health Care Pneumonia Poisoning Population Prevention Psychiatric services Public health Risk factors Suicide Suicide - psychology Suicides & suicide attempts Surgery Taiwan - epidemiology Teenagers Ulcers Urbanization Victims
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Summary:	This study examined the pattern of medical utilization and the distribution of comorbidities shortly before death among adolescents who died from suicide and compared these data with those of living controls. From Taiwan's National Health Insurance Research Database, this study identified adolescents aged 10-19 years who died from suicide ( = 935) between 1 January 2000, and 31 December 2016, by linking each patient with the national mortality database. The researchers conducted a nested case-control study through risk set sampling, and for each case, 20 age- and sex-matched controls ( = 18 700) were selected from the general population. The researchers applied conditional logistic regression to investigate differences in medical utilization and physical and psychiatric comorbidities between cases and controls. Cases had a higher proportion of contact with the psychiatric department but a similar proportion of contact with any non-psychiatric medical department within 1 year before suicide compared with controls. There were 18.6% of adolescent suicide victims who only had contacted with a psychiatric department 3 months before suicide. Moreover, cases had a higher proportion of contact with non-psychiatric services within 3 months before suicide, particularly with emergency, surgery, and internal medicine departments. Cases had higher risks of several psychiatric disorders and physical illnesses, including heart diseases, pneumonia, and ulcer disease, than did controls. The findings of increased medical utilization and higher risks of physical and psychiatric comorbidities in adolescent suicide victims are crucial for developing specific interventions to prevent suicide in this population.
ISSN:	0033-2917 1469-8978