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

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.