Pediatric emergency medicine trisk 4180 4180
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TABLE 126.12
CHARACTERISTICS ASSOCIATED WITH CHILDHOOD AND
ADOLESCENT SUICIDE ATTEMPTS
Positive family history
Hopelessness
Low self-esteem
Active desire to die
Depression
Anger/desire for revenge
TABLE 126.13
ASSESSING CHILDHOOD/ADOLESCENT SUICIDE ATTEMPTS:
FOUR MAJOR DIMENSIONS
Medical lethality
Suicidal intent
Impulsivity
Strengths/supports
The psychiatric evaluation should include an assessment of the actual and
believed medical lethality of the act, the suicidal intent, the impulsivity of
the act, and the strengths and supports within the family ( Table 126.13 ).
The lethality of a suicide attempt by itself may be misleading because
suicidal children may over- or underestimate the harm intended. In general,
more violent methods of attempted suicide (e.g., hanging, shooting,
jumping) often reflect greater suicidal intent ( Table 126.14 ). However, the
physician cannot conclude that attempts with low lethality are not serious
attempts until they have specifically asked about and assessed the child’s
suicidal intent, that is, determined how seriously the child wanted to end
their life ( Table 126.15 ). These questions should be asked of the child
without the parents in the room.
The physician should gather as much information as possible about the
attempt itself to help infer the degree of suicidal intent on the part of the
