Emergency department visits for attempted suicide and self harm in the USA: 2006–2013
Open accessAbstract
Aims.: To characterise and identify nationwide trends in suicide-related emergency department (ED) visits in the USA from 2006 to 2013. Methods.: We used data from the Nationwide Emergency Department Sample (NEDS) from 2006 to 2013. E-codes were used to identify ED visits related to suicide attempts and self-inflicted injury. Visits were characterised by factors such as age, sex, US census region, calendar month, as well as injury severity and mechanism. Injury severity and mechanism were compared between age groups and sex by chi-square tests and Wilcoxon rank-sum tests. Population-based rates were computed using US Census data. Results.: Between 2006 and 2013, a total of 3 567 084 suicide attempt-related ED visits were reported. The total number of visits was stable between 2006 and 2013, with a population-based rate ranging from 163.1 to 173.8 per 100 000 annually. The frequency of these visits peaks during ages 15–19 and plateaus during ages 35–45, with a mean age at presentation of 33.2 years. More visits were by females (57.4%) than by males (42.6%); however, the age patterns for males and females were similar. Visits peaked in late spring (8.9% of all visits occurred in May), with a smaller peak in the fall. The most common mechanism of injury was poisoning (66.5%), followed by cutting and piercing (22.1%). Males were 1.6 times more likely than females to use violent methods to attempt suicide (OR = 1.64; 95% CI = 1.60–1.68;p< 0.001). The vast majority of patients (82.7%) had a concurrent mental disorder. Mood disorders were the most common (42.1%), followed by substance-related disorders (12.1%), alcohol-related disorders (8.9%) and anxiety disorders (6.4%). Conclusions.: The annual incidence of ED visits for attempted suicide and self-inflicted injury in the NEDS is comparable with figures previously reported from other national databases. We highlighted the value of the NEDS in allowing us to look in depth at age, sex, seasonal and mechanism patterns. Furthermore, using this large national database, we confirmed results from previous smaller studies, including a higher incidence of suicide attempts among women and individuals aged 15–19 years, a large seasonal peak in suicide attempts in the spring, a predominance of poisoning as the mechanism of injury for suicide attempts and a greater use of violent mechanisms in men, suggesting possible avenues for further research into strategies for prevention.
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
On average intentional ingestions of analgesics contributed to 4.9 (range 0.4-26.0) poisonings per 100,000 population per year, with data only available for four countries.
“On average intentional ingestions of analgesics contributed to 4.9 (range 0.4-26.0)poisonings per 100,000 population per year, with data only available for four countries (Supplementary Figure S5) [148,188,192,195].”
From Paracetamol (acetaminophen) overdose and hepatotoxicity: mechanism, treatment, prevention measures, and estimates of burden of disease (2023) · cites this paper as [192]
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
The self-check needs the paper’s full text.
Cites
Centers for Disease Control and Prevention
Branum, A. (2007) · Sage eBooks · doi:10.4135/9781412952644.n74 · Cited by 6,434 · see citing works
Reducing Suicide--A National Imperative
(2002) · PsycEXTRA Dataset · doi:10.1037/e719942007-001 · Cited by 947 · see citing works
National Hospital Ambulatory Medical Care Survey: 2019 Emergency Department Summary Tables
Cairns, C., & Kang, K. (2022) · doi:10.15620/cdc:115748 · Cited by 725 · see citing works
Risk factors for suicide in later life
Conwell, Y., Duberstein, P. R., & Caine, E. D. (2002) · Biological Psychiatry · doi:10.1016/s0006-3223(02)01347-1 · Cited by 701 · see citing works
Rating the Severity of Tissue Damage
(1971) · JAMA · doi:10.1001/jama.1971.03180150059012 · Cited by 524 · see citing works
Suicidal Thoughts and Behaviors Among Adults Aged ≥18 Years — United States, 2015–2019
Ivey-Stephenson, A. Z., Crosby, A. E., Hoenig, J. M., Gyawali, S., Park-Lee, E., & Hedden, S. L. (2022) · MMWR. Surveillance Summaries · doi:10.15585/mmwr.ss7101a1 · Cited by 512 · see citing works
An introduction to the Barell body region by nature of injury diagnosis matrix
Barell, V., Aharonson‐Daniel, L., Fingerhut, L. A., et al. (2002) · Injury Prevention · doi:10.1136/ip.8.2.91 · Cited by 384 · see citing works
Wilkinson, P. O., & Goodyer, I. M. (2011) · European Child & Adolescent Psychiatry · doi:10.1007/s00787-010-0156-y · Cited by 297 · see citing works
Method Choice, Intent, and Gender in Completed Suicide
Denning, D. G., Conwell, Y., King, D. A., & Cox, C. (2000) · Suicide and Life-Threatening Behavior · doi:10.1111/j.1943-278x.2000.tb00992.x · Cited by 279 · see citing works
Suicidal thoughts and behaviors among adults aged ≥18 years--United States, 2008-2009.
Crosby, A. E., Han, B., Ortega, L., Parks, S. E., & GFROERER, J. (2011) · PubMed · Cited by 278 · see citing works
Trends in US emergency department visits for attempted suicide and self-inflicted injury, 1993-2008.
Ting, S. A., Sullivan, A. F., Boudreaux, E. D., Miller, I., & Camargo, C. A. (2012) · General Hospital Psychiatry · doi:10.1016/j.genhosppsych.2012.03.020 · Cited by 252 · see citing works
Doshi, A., Boudreaux, E., Wang, N., Pelletier, A. J., & Camargo, C. (2005) · Annals of Emergency Medicine · doi:10.1016/j.annemergmed.2005.04.018 · Cited by 245 · see citing works
Reducing Suicide: A National Imperative
Wong, N. (2003) · American Journal of Psychiatry · doi:10.1176/appi.ajp.160.8.1534 · Cited by 229 · see citing works
Is Violent Method of Suicide a Behavioral Marker of Lifetime Aggression?
Dumais, A., LESAGE, A. D., Lalovic, A., Séguin, M., Tousignant, M., Chawky, N., & Turecki, G. (2005) · American Journal of Psychiatry · doi:10.1176/appi.ajp.162.7.1375 · Cited by 205 · see citing works
Meares, R. A., Mendelsohn, F. A. O., & Milgrom‐Friedman, J. (1981) · The British Journal of Psychiatry · doi:10.1192/bjp.138.4.321 · Cited by 141 · see citing works
TEMPORAL VARIATION IN SUICIDE AND HOMICIDE
Lester, D. (1979) · American Journal of Epidemiology · doi:10.1093/oxfordjournals.aje.a112709 · Cited by 123 · see citing works
Clark, D. E., Osler, T. M., & Hahn, D. R. (2009) · RePEc: Research Papers in Economics · Cited by 122 · see citing works
Wilkinson, P. O. (2012) · European Child & Adolescent Psychiatry · doi:10.1007/s00787-012-0365-7 · Cited by 114 · see citing works
Validation of ICDPIC software injury severity scores using a large regional trauma registry
Greene, N. H., Kernic, M. A., Vavilala, M. S., & Rivara, F. P. (2015) · Injury Prevention · doi:10.1136/injuryprev-2014-041524 · Cited by 94 · see citing works
SHORT-TERM TEMPORAL CYCLES IN THE FREQUENCY OF SUICIDE, UNITED STATES, 1972–19781
MacMahon, K. L. (1983) · American Journal of Epidemiology · doi:10.1093/oxfordjournals.aje.a113608 · Cited by 80 · see citing works
Nonfatal self-inflicted injuries treated in hospital emergency departments--United States, 2000.
(2002) · PubMed · Cited by 39 · see citing works
From psychiatric symptom to diagnostic category: self-harm from the Victorians to DSM-5
Gilman, S. L. (2013) · History of Psychiatry · doi:10.1177/0957154x13478082 · Cited by 30 · see citing works
ED use by older adults attempting suicide
Carter, M., & Reymann, M. R. (2014) · The American Journal of Emergency Medicine · doi:10.1016/j.ajem.2014.02.003 · Cited by 30 · see citing works
Sulyman, N., Kim, M. K., Rampa, S., Allareddy, V., Nalliah, R. P., & Allareddy, V. (2013) · PLoS ONE · doi:10.1371/journal.pone.0069874 · Cited by 20 · see citing works
Flagged first, then by citations
Research works printed but not linked: 1
- MacMahon K (1983). Short-term temporal cycles in the frequency of suicide. American Journal of Epidemiology 117, 755-750.
Cited by
Sorted by citations
Suicide Case-Fatality Rates in the United States, 2007 to 2014: A Nationwide Population-Based Study
Conner, A., Azrael, D., & Miller, M. (2019) · Annals of Internal Medicine · doi:10.7326/m19-1324 · Cited by 286 · see citing works
Chidiac, A. S., Buckley, N. A., Noghrehchi, F., & Cairns, R. (2023) · Expert Opinion on Drug Metabolism & Toxicology · doi:10.1080/17425255.2023.2223959 · Cited by 215 · see citing works
- Authors
- Canner, J. K., Giuliano, K., Selvarajah, S., Hammond, E. R., & Schneider, E. B.
- Affiliations
- Johns Hopkins University (US)
- Kennedy Krieger Institute (US)
- Brigham and Women's Hospital (US)
- Corresponding author
- Canner, J. K.
- Venue
- Epidemiology and Psychiatric Sciences
- Publisher
- Cambridge University Press (CUP)
- Published
- 2016-11-17
- Volume
- 27
- Issue
- 1
- Pages
- 94-102
- ISSN
- 2045-7960 (ISSN-L)
- 2045-7979
- PMC
- PMC6999001
- OpenAlex
- W2549390881
- Cited by
- 140
- References
- 24
- Citations by year
- 2026: 8 · 2025: 6 · 2024: 9 · 2023: 8 · 2022: 14 · 2021: 13 · 2020: 23 · 2019: 22 · 2018: 31 · 2017: 3 · 2016: 1 · 2015: 1
- FWCI
- 25.40
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Epidemiology and Psychiatric Sciences (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Suicide and Self-Harm Studies
- Social Sciences › Sociology and Political Science › Homicide, Infanticide, and Child Abuse
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Injury Epidemiology and Prevention
- Keywords
- suicide attempts, self-harm, emergency department visits, injury severity, injury mechanisms, poisoning, seasonal variation, sex differences, age differences, mood disorders, substance-related disorders, alcohol-related disorders, anxiety disorders, Nationwide Emergency Department Sample, incidence trends, United States, suicide prevention, access to mental health care, health disparities
- MeSH terms
- Adolescent, Adult, Emergency Service, Hospital, Female, Hospitalization, Humans, Male, Middle Aged, Poisoning, Self Mutilation, Suicide, Attempted, United States, Incidence, Self-Injurious Behavior, Age Distribution, Sex Distribution, Young Adult
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
