Back to Annual Meeting

Back to Annual Meeting

APHA Scientific Session and Event Listing

Recorded presentation

Gregory L. Larkin, MD, MSPH, FACEP, Surgery/Emergency Medicine, UT Southwestern Medical School, 5323 Harry Hines Blvd., Dallas, TX 75390-8579, 214-648-2904, gregory.larkin@utsouthwestern.edu

OBJECTIVES: To measure the association between medication use and suicidal ideation (SI) in a multiethnic, non-psychiatric emergency department population. METHODS:Prospective cohort of ambulatory adult (>18years) patients recruited during random time blocks using a bilingual, computerized, confidential, mental health screen in an urban, 145,000-visit ED. Patients presenting with overt mental health complaints were excluded. Uni- and multivariate comparisons were made with chi-square and logistic regression to assess differences of proportion between ideators and non-ideators. RESULTS: The sample of 1,590 patients was representative of the overall ED population, with 29% white, 39% African American, and 32% Hispanic ethnicity; 845 (53%) were male. Suicidal ideation was present in 184 (11.6%) but did not differ by age, gender, insurance status, marital status, employment status or presenting complaint. Multivariate logistic regression models with 100 bootstraps confirmed that SI was significantly higher among non-Hispanic blacks than non-blacks (14.2% v. 9.9%; p < .01), those with exposure to a significantly traumatic life events (21.1% vs 6.0%; p<0.001 ), those with at risk or binge drinking, (15.4% vs. 10.0%; p<0.01), and those on the following medications: antipsychotics (26.9% SI), analgesics (19.4% SI), and anti-lipid agents (17.1% SI). Antidepressants were associated with SI in only 10.7% of cases and were confirmed in multivariate modeling not to be predictive of suicidal ideation in this cohort. Specific plans for suicide were present in 2% of the overall sample. CONCLUSION: The use of medications other than antidepressants were significantly associated with suicidal ideation in this multiethnic cohort of non-psychiatric ED patients.

Learning Objectives: At the conclusion of the session, the participant in this session will be able to

• Recognize the feasibility of mass screening for suicidality in Emergency Department populations.
• Describe the association between clinical and demographic factors and suicidal ideation in a non-psychiatric population.
• Identify the link between suicidality and medication use.

Keywords: Suicide, Medicine

Presenting author's disclosure statement:

Any relevant financial relationships? No

Recorded presentation