Adolescent suicide attempts: sociodemographic, psychiatric characteristics, and follow-up challenges in a clinical setting

Meryem Kaşak; Yusuf Selman Çelik; Sidre Karakolcu; Zehra Betül Özdemir; Dilanur Cınbırtoğlu; Reyyan Nazlıgül

doi:10.22391/fppc.1542350

Research Article

Adolescent suicide attempts: sociodemographic, psychiatric characteristics, and follow-up challenges in a clinical setting

Year 2025, Volume: 10 Issue: 1, 11 - 19, 20.03.2025

Meryem Kaşak , Yusuf Selman Çelik , Sidre Karakolcu , Zehra Betül Özdemir , Dilanur Cınbırtoğlu , Reyyan Nazlıgül

https://doi.org/10.22391/fppc.1542350

Abstract

Introduction: Suicide is a leading cause of death across all age groups, with a significant increase during adolescence. This study aimed to identify the sociodemographic characteristics of adolescents referred to Child and Adolescent Mental Health (CAMHS) specialists due to a suicide attempt within a one-year period at Ankara Etlik City Hospital, one of the leading centers in the region. The study also investigated the presence of pre-attempt psychiatric diagnoses, characteristics of suicidal acts, factors affecting post-attempt treatment and follow-up processes, and determined the necessary measures to prevent suicidal behavior in this age group.
Methods: The study retrospectively reviewed the records of all patients who were presented with suicide attempts to the Pediatric Emergency Department of Ankara Etlik City Hospital between April 1, 2023, and April 1, 2024. Psychiatric diagnoses were made based on clinical interviews conducted by a consultant psychiatrist using DSM-5 criteria. Data collected included demographic characteristics (age, gender, family structure), psychiatric status prior to the suicidal act (pre-existing psychiatric disorders, history of psychiatric hospitalization, self-harm/suicide attempt history, and psychiatric treatment or follow-up), characteristics of the suicidal act (time, method, reason, and whether the act was disclosed to a relative), current psychiatric diagnoses, and details of psychiatric treatment and follow-up post-attempt (expression of regret, need for intensive care, type of psychiatric treatment, and adherence to follow-ups).
Results: Of the 207 cases (mean age: 15.97±1.4 years) evaluated for suicide attempts by CAMHS specialists within one year, 79.7% (n=165) were female, and 20.3% (n=42) were male. While 56% (n=116) had a history of psychiatric disorders, nearly half did not attend psychiatric follow-ups regularly. Upon post-attempt evaluation, 67.62% (n=140) were diagnosed with a psychiatric disorder, with depressive disorder being the most common (42.5%, n=88). Among patients who expressed regret on post-suicide attempt, 99.4% (n=164) were discharged and referred for outpatient follow-up. It was determined that the presence of psychiatric comorbidities and the use of non-pharmacological methods in suicide attempts increased the likelihood of psychotropic medication initiation by clinicians, and those prescribed psychotropic medications adhered more regularly to follow-ups.
Conclusions: Understanding how and why suicide risk emerges during adolescence is the first step toward a preventive approach by accurately identifying risk factors. Measures aimed at improving adolescents' treatment adherence are crucial in preventing the recurrence of attempts and reducing the risk of death.

Keywords

Suicide, adolescent, risk factors, prevention, regret

Ethical Statement

Ethical approval for this study was obtained from the Scientific Research Evaluation and Ethics Committee of Ankara Etlik City Hospital (No: AEŞH-BADEK-2024-469, Date: 22/05/2024). As the study was retrospective, informed consent could not be obtained. Personal information of the individuals was not recorded during data collection.

Thanks

We thank Ayşegül Efe and Yusuf Öztürk for their supervision during the manuscript writing process.

References

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Ergen intihar girişimleri: sosyodemografik, psikiyatrik özellikler ve klinik bir ortamda takip süreçlerindeki zorluklar

Year 2025, Volume: 10 Issue: 1, 11 - 19, 20.03.2025

Meryem Kaşak , Yusuf Selman Çelik , Sidre Karakolcu , Zehra Betül Özdemir , Dilanur Cınbırtoğlu , Reyyan Nazlıgül

https://doi.org/10.22391/fppc.1542350

Abstract

Giriş: İntihar, tüm yaş gruplarında önde gelen bir ölüm nedeni olmakla birlikte, özellikle ergenlik döneminde belirgin artış görülmektedir. Bu çalışmada, bölgenin önde merkezlerinden biri olan Ankara Etlik Şehir Hastanesi’nde bir yıllık süre içinde intihar girişimi nedeniyle çocuk ve ergen ruh sağlığı ve hastalıkları (ÇERSAH) uzmanlarına danışılan ergenlerin sosyodemografik özellikleri, eylem öncesi psikiyatrik tanı varlığı, gerçekleştirdikleri eyleme ilişkin özellikler, eylem sonrası tedavi ve takip süreçlerini etkileyen faktörler tanımlanmış ve bu yaş grubu için intihar davranışının önlenmesi için gerekli tedbirlerin belirlenmesi amaçlanmıştır.
Yöntem: Çalışma, 01 Nisan 2023 ile 01 Nisan 2024 tarihleri arasında Ankara Etlik Şehir Hastanesi Çocuk Acil Servisine intihar girişimi ile başvuran tüm hastaların dosyaları retrospektif olarak değerlendirilerek gerçekleştirildi. Psikiyatrik tanılar, bir konsültan psikiyatrist tarafından yapılan klinik görüşmeye dayanarak ve DSM-5 tanı ölçütlerine göre konulmuştur. Olguların demografik özellikleri (yaş, cinsiyet, aile yapısı), intihar davranışı öncesindeki psikiyatrik durum (önceden var olan psikiyatrik hastalıkları, psikiyatri servisine yatış öyküsü, kendine zarar verme/intihar girişimi öyküsü, psikiyatrik tedavi veya takip yapılıp/yapılmadığı), intihar davranışının özellikleri (zamanı, kullanılan yöntem, nedeni, yakınına haber verip/vermediği), güncel psikiyatrik tanıları, intihar davranışı sonrasındaki psikiyatrik tedavi ve takip bilgileri (pişmanlık olup/olmadığı, yoğun bakım gereksinimi, uygulanan psikiyatrik tedavi türü, takiplere düzenli gelip/gelmeme durumu) kaydedilmiştir.
Bulgular: Bir yıl içinde ÇERSAH uzmanlarının intihar girişimi nedeniyle değerlendirdiği 207 hastanın (yaş ortalaması: 15,97±1,4 yıl) cinsiyet dağılımları %79,7’si (n=165) kız ve %20,3’ü (n=42) erkek şeklindedir. Olguların %56’sının (n=116) psikiyatrik hastalık öyküsü olmasına rağmen, yaklaşık yarısının psikiyatri takiplerine düzenli gitmediği, olguların intihar girişimi sonrası yapılan değerlendirmede olguların %67,62’sinin (n=140) psikiyatrik hastalığa sahip olduğu ve en sık %42,5 (n =88) ile depresif bozukluk tanısının eşlik ettiği saptanmıştır. İntihar sonrası pişmanlık ifade eden hastaların %99,4’ünün (n=164) taburcu edildiği ve klinisyen tarafından poliklinik takibine yönlendirildiği gösterilmiştir. Psikiyatrik komorbidite varlığının ve farmakolojik olmayan yöntemlerle intihar girişiminde bulunmanın klinisyen tarafından psikotrop ilaç başlama sıklığını artırdığı ve psikotrop ilaç başlanan hastaların takiplere daha düzenli katıldığı belirlendi.
Sonuç: İntihar riskinin ergenlik döneminde nasıl ve neden ortaya çıktığının anlaşılması risk faktörlerinin doğru tespitini sağlayarak koruyucu yaklaşım için ilk adım olacaktır. Ergenlerin tedavi uyumunu arttırmak için alınacak önlemler girişimin tekrarlamasını ve ölümle sonuçlanmasını engellemek açısından oldukça önemlidir.

Keywords

İntihar, ergen, risk faktörleri, önleme, pişmanlık

Ethical Statement

Thanks

We thank Ayşegül Efe and Yusuf Öztürk for their supervision during the manuscript writing process.

References

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2. World Health Organization. Disease Burden and Mortality Estimates: Cause-Specific Mortality, 2000-2016. Geneva: World Health Organization. (2018).
3. Nock MK, Borges G, Bromet EJ, Alonso J, Angermeyer M, Beautrais A, et al. Cross-national prevalence and risk factors for suicidal ideation, plans and attempts. The British Journal of Psychiatry. 2008;192:98–105. https://doi.org/10.1192/bjp.bp.107.040113
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6. Miranda-Mendizabal A, Castellví P, Parés-Badell O, Alayo I, Almenara J, Alonso I, et al. Gender differences in suicidal behavior in adolescents and young adults: systematic review and meta-analysis of longitudinal studies. Int J Public Health. 2019;64:265–83. https://doi.org/10.1007/s00038-018-1196-1
7. Ye Z, Xiong F, Li W. A meta-analysis of co-occurrence of non-suicidal self-injury and suicide attempt: implications for clinical intervention and future diagnosis. Front Psychiatry. 2022;13:976217. https://doi.org/10.3389/fpsyt.2022.976217
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9. McLoughlin AB, Gould MS, Malone KM. Global trends in teenage suicide: 2003–2014. QJM: An International Journal of Medicine. 2015;108(10):765–80. https://doi.org/10.1093/qjmed/hcv026
10. Soole R, Kõlves K, De Leo D. Suicide in children: a systematic review. Archives of Suicide Research. 2015;19(3):285–304. https://doi.org/10.1080/13811118.2014.996694
11. Hulten A, Jiang G-X, Wasserman D, Hawton K, Hjelmeland H, De Leo D, et al. Repetition of attempted suicide among teenagers in Europe: frequency, timing and risk factors. Eur Child Adolesc Psychiatry. 2001;10:161–9. https://doi.org/10.1007/s007870170022
12. Gili M, Castellví P, Vives M, de la Torre-Luque A, Almenara J, Blasco MJ, et al. Mental disorders as risk factors for suicidal behavior in young people: A meta-analysis and systematic review of longitudinal studies. J Affect Disord. 2019;245:152–62. https://doi.org/10.1016/j.jad.2018.10.115
13. Mirkovic B, Cohen D, Garny de la Rivière S, Pellerin H, Guilé J-M, Consoli A, et al. Repeating a suicide attempt during adolescence: risk and protective factors 12 months after hospitalization. Eur Child Adolesc Psychiatry. 2020;29:1729–40. https://doi.org/10.1007/s00787-020-01491-x
14. Rotheram-Borus MJ, Piacentini J, Miller S, Graae F, Dunne E, Cantwell C. Toward improving treatment adherence among adolescent suicide attempters. Clin Child Psychol Psychiatry. 1996;1:99–108. https://doi.org/10.1177/1359104596011009
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19. Nock MK, Borges G, Bromet EJ, Cha CB, Kessler RC, Lee S. Suicide and suicidal behavior. Epidemiol Rev. 2008;30(1):133. https://doi.org/10.1093/epirev/mxn002
20. Hawton K, Harriss L. Deliberate self‐harm by under‐15‐year‐olds: characteristics, trends and outcome. Journal of Child Psychology and Psychiatry. 2008;49(4):441–8. https://doi.org/10.1111/j.1469-7610.2007.01852.x
21. Aktepe E, Kandil S, Goker Z, Sarp K, Topbas M, Ozkorumak E. [Evaluation of sociodemographic and psychiatric characteristics in children and adolescents who attempted suicide] (in Turkish). TAF Preventive Medicine Bulletin. 2006;5(6):444-54.
22. Eskin M, AlBuhairan F, Rezaeian M, Abdel-Khalek AM, Harlak H, El-Nayal M, et al. Suicidal thoughts, attempts and motives among university students in 12 Muslim-majority countries. Psychiatric Quarterly. 2019;90:229–48. https://doi.org/10.1007/s11126-018-9613-4
23. Cha CB, Franz PJ, M Guzmán E, Glenn CR, Kleiman EM, Nock MK. Annual Research Review: Suicide among youth–epidemiology, (potential) etiology, and treatment. Journal of Child Psychology and Psychiatry. 2018;59(4):460–82. https://doi.org/10.1111/jcpp.12831
24. MacLean J, Kinley DJ, Jacobi F, Bolton JM, Sareen J. The relationship between physical conditions and suicidal behavior among those with mood disorders. J Affect Disord. 2011;130(1-2):245–50. https://doi.org/10.1016/j.jad.2010.10.028
25. Horwitz AG, Czyz EK, King CA. Predicting future suicide attempts among adolescent and emerging adult psychiatric emergency patients. Journal of Clinical Child & Adolescent Psychology. 2015;44(5):751–61. https://doi.org/10.1080/15374416.2014.910789
26. Ulusoy D, Demir NO, Baran AG. [Suicide perception in adolescence: The case of senior high school youth] (in Turkish). Hacettepe University Journal of Faculty of Letters. 2005;22(1):259-70.
27. Groschwitz RC, Kaess M, Fischer G, Ameis N, Schulze UM, Brunner R, et al. The association of non-suicidal self-injury and suicidal behavior according to DSM-5 in adolescent psychiatric inpatients. Psychiatry research. 2015;228(3):454-61. https://doi.org/10.1016/j.psychres.2015.06.019
28. Eraslan AN, Gorucu RA, Ozturk M, Yılmaz A, Tasar MA. Evaluation of sociodemographic characteristics and depression diagnosis of adolescents who had suicide attempt. Anatolian Journal Of General Medical Research. 2021;31(3):322-32.
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30. Griep SK, MacKinnon DF. Does nonsuicidal self-injury predict later suicidal attempts? A review of studies. Archives of Suicide Research. 2022;26(2):428–46. https://doi.org/10.1080/13811118.2020.1822244
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There are 47 citations in total.

Details

Primary Language	English
Subjects	Child and Adolescent Psychiatry
Journal Section	Original Research
Authors	Meryem Kaşak 0000-0003-0176-868X Yusuf Selman Çelik 0000-0002-1131-2814 Sidre Karakolcu 0009-0005-1908-5133 Zehra Betül Özdemir 0009-0008-8061-7399 Dilanur Cınbırtoğlu 0009-0009-1507-5658 Reyyan Nazlıgül 0009-0007-0944-0394
Publication Date	March 20, 2025
Submission Date	September 3, 2024
Acceptance Date	February 20, 2025
Published in Issue	Year 2025Volume: 10 Issue: 1

Cite

APA	Kaşak, M., Çelik, Y. S., Karakolcu, S., Özdemir, Z. B., et al. (2025). Adolescent suicide attempts: sociodemographic, psychiatric characteristics, and follow-up challenges in a clinical setting. Family Practice and Palliative Care, 10(1), 11-19. https://doi.org/10.22391/fppc.1542350
AMA	Kaşak M, Çelik YS, Karakolcu S, Özdemir ZB, Cınbırtoğlu D, Nazlıgül R. Adolescent suicide attempts: sociodemographic, psychiatric characteristics, and follow-up challenges in a clinical setting. Fam Pract Palliat Care. March 2025;10(1):11-19. doi:10.22391/fppc.1542350
Chicago	Kaşak, Meryem, Yusuf Selman Çelik, Sidre Karakolcu, Zehra Betül Özdemir, Dilanur Cınbırtoğlu, and Reyyan Nazlıgül. “Adolescent Suicide Attempts: Sociodemographic, Psychiatric Characteristics, and Follow-up Challenges in a Clinical Setting”. Family Practice and Palliative Care 10, no. 1 (March 2025): 11-19. https://doi.org/10.22391/fppc.1542350.
EndNote	Kaşak M, Çelik YS, Karakolcu S, Özdemir ZB, Cınbırtoğlu D, Nazlıgül R (March 1, 2025) Adolescent suicide attempts: sociodemographic, psychiatric characteristics, and follow-up challenges in a clinical setting. Family Practice and Palliative Care 10 1 11–19.
IEEE	M. Kaşak, Y. S. Çelik, S. Karakolcu, Z. B. Özdemir, D. Cınbırtoğlu, and R. Nazlıgül, “Adolescent suicide attempts: sociodemographic, psychiatric characteristics, and follow-up challenges in a clinical setting”, Fam Pract Palliat Care, vol. 10, no. 1, pp. 11–19, 2025, doi: 10.22391/fppc.1542350.
ISNAD	Kaşak, Meryem et al. “Adolescent Suicide Attempts: Sociodemographic, Psychiatric Characteristics, and Follow-up Challenges in a Clinical Setting”. Family Practice and Palliative Care 10/1 (March 2025), 11-19. https://doi.org/10.22391/fppc.1542350.
JAMA	Kaşak M, Çelik YS, Karakolcu S, Özdemir ZB, Cınbırtoğlu D, Nazlıgül R. Adolescent suicide attempts: sociodemographic, psychiatric characteristics, and follow-up challenges in a clinical setting. Fam Pract Palliat Care. 2025;10:11–19.
MLA	Kaşak, Meryem et al. “Adolescent Suicide Attempts: Sociodemographic, Psychiatric Characteristics, and Follow-up Challenges in a Clinical Setting”. Family Practice and Palliative Care, vol. 10, no. 1, 2025, pp. 11-19, doi:10.22391/fppc.1542350.
Vancouver	Kaşak M, Çelik YS, Karakolcu S, Özdemir ZB, Cınbırtoğlu D, Nazlıgül R. Adolescent suicide attempts: sociodemographic, psychiatric characteristics, and follow-up challenges in a clinical setting. Fam Pract Palliat Care. 2025;10(1):11-9.