Suicidality among adolescents and young adults in a Psychiatry Inpatient Unit: a two-year retrospective study in Umbria, central Italy

Abstract

Introduction Suicide is the fourth leading cause of death among adolescents and young adults (AYA) (Czyz EK, King CA. J Clin Child Adolesc Psychol.2015;44(1):181-19), and psychiatric disorders are a major contributing factor (WHO Global Health Estimates 2000-2019). Studies focusing on suicidality in Italian inpatients samples are scant. Objectives The present cross-sectional study aimed to define clinical variables associated with suicidality related phenomena in a sample of young inpatients. The main objectives were to assess the prevalence of suicidal ideation and deliberate self-harm in inpatients aged 16–24 years and to determine the relationship between suicidal behaviours and psychiatric disorders. Methods This retrospective study was conducted in a naturalistic setting, at the Psychiatric Inpatient Unit, Perugia Hospital/Local Mental Health Unit 1, from January 2018 to December 2019. Sociodemographic information, clinical history, diagnostic and treatment features were collected. Descriptive and bivariate analyses were performed (p<0,05). Results Among 120 patients (14,2% of the overall 850 hospitalizations in the index period) admitted for suicidality-related phenomena, 21 (17,5%) were AYA. Admission was due to deliberate self-harm in 85,7% (n=18) and to suicidal ideation in 14,3% (n=3) cases. Personality disorders (p=0.006), were significantly more prevalent among AYA, while mood disorders were more frequent among adults (p=0.0018) (Tab.1). Tab.1. Differences in diagnostic features between AYA and adult population. AYAn (%) Adultsn (%) χ2 P PERSONALITY DISORDERS 10 (47.6) 17 (17,2) 7.547 0.006 Borderline personality disorder 7 (33.3) 9 (9.1) 6.838 0.009 MOOD DISORDERS 0 (0) 26 (26,3) 5.578 0.018 Conclusions Personality is under construction among youths, and affective symptoms may have unusual characteristics (Lack CW, Green AL. J Pediatr Nurs. 2009;24(1):13-25), as demonstrated by the fact that irritable rather than depressed mood is a core diagnostic mood symptom for adolescents (Rice F, et al. J Affect Disord. 2019;243:175-181). We hypothesized that symptoms of irritability, emotional dysregulation, and impulsivity could be linked to suicidality (Ghanem M, et al. Arch Suicide Res. 2013;17(3):262-274). Further investigations are needed for the characterization of AYA inpatients who experience suicidal thoughts or self-injurious behaviours, in order to redefine preventive tools and reduce suicide mortality rates. Disclosure of Interest None Declared