Osvaldo Bello

Intentos de autoeliminación en menores de 15 años: Experiencia en un Servicio de Urgencias

INTRODUCTION Suicide attempt (SA) in under 15s is one of the most frequent reasons for psychiatric consultation faced by paediatricians working in urgency services. Uruguay is the country with the highest suicide rate in South America. Suicide is currently the fifth cause of death in 10 to 14 year olds (1.8/ 100,000) and ninth in the 5 to 9 age group (0.4/100,000). OBJECTIVES To know the incidence of SA consultations in under 15s, the characteristics of their environment and methods used. MATERIAL AND METHODS Descriptive and prospective epidemiological study in a paediatric urgency service between 01/07/08 and 30/06/09. RESULTS A total of 145 patients were included. Mean age was 12 yrs. 7 m. A 77% were female. The triggering factors were: interpersonal conflicts (57%), affective losses (17%) and battering or sexual-abuse (11%). A 78% took medication. An 18% planned the SA. A 77% occurred at home. The life of 10% was at risk. One third had at least one previous SA. A 49% had a family history of psychiatric disorders, 28% of SA and 7% of suicide. Of the total 123 SA with pills, 101 were women (n 112) and 22 males (n 33) (p <0.05). Eight out of 15 under 10 year olds were male, and 25 out of 130 had more than 10 years of age (p <0.05). Among under 10s, 50% used a non-pharmacological method and this figure rose to 19% (p <0.05) in those with more than 10 years. An 88% rectified or regretted their action. Median length of hospital stay was 6 days. At the time of discharge, 99.5% did not present sequelae. CONCLUSIONS SA incidence in under 15s is 2/1,000 consultations per year. The main profile is a female between 12 and 14 years of age that attempts suicide at home using medication, preferably benzodiacepines, following a discussion or affective loss, without life risk. Among those under 10 years, there is a significant predominance of males using non pharmacological methods. Verification of these behavioural patterns will enable the design of prevention strategies in the age group studied.