Biomedical subjects

D F Vorters

Publications and source records attributed to D F Vorters.

3 recordsLinked to original sources

PubMed1992

Adolescent suicide attempters: do physicians recognize them?

The single most important risk factor for adolescent suicide is a previous attempt. It is unclear if physicians can identify adolescents who have attempted suicide. Our objectives were to determine the prevalence of previous attempts in an adolescent clinic population, if physicians identify attempters, and if attempters demonstrate persistent distress. Of 332 patients aged 12-19 years attending a medical clinic, 48 (14.5%) reported a previous attempt. The physician's visit note documented that only 8 (16.7%) of the 48 attempters were asked about suicidal behavior. Attempters were more likely than nonattempters (p less than 0.05) to be female; to come to clinic without a guardian; to give a chief complaint pertaining to sexually transmitted disease, obstetrics-gynecology, or mental health; and to report previous mental health care. Attempters had poorer mean scores (p less than 0.05) on validated subscales for family relationships, social competence, depression, unpopularity, somatic complaints, thought disorders, delinquency, aggression, and identity. We conclude that suicide attempts are common among adolescent clinic patients, that physicians may not recognize attempters, and that attempters remain distressed and in need of care. Physicians who see adolescents for routine medical problems must consider the potential for self-destructive behavior, regardless of the presenting complaint.

Adolescent↗

PubMed1991

Risk factors for injury during adolescence.

Injuries kill more American adolescents than all other diseases combined. It is unclear, however, if adolescents are able or willing to provide the information necessary to characterize their risk for injury. Our objective was to determine if adolescents hospitalized for severe injury are more likely than those hospitalized for acute illness to describe risk factors for injury such as: previous injury, family dysfunction, recent stress, or substance use. All patients completed the Offer Self-Image Questionnaire, the Life-Events Scale for Adolescents, the Adolescent Alcohol-Involvement Scale, and the NIDA Adolescent Drug Use Survey. There were no differences between injured and ill adolescents in demographics, impulse control, emotional tone, perceived family function, alcohol scores, or use of cigarettes, marijuana, or other illicit drugs. The groups differed significantly in sex, previous serious injury, previous hospitalization for injury, injury after alcohol or drug use, and life-event scores. The most common life stresses reported were parental or sibling hospitalization, death of a grandparent, school failure or suspension, getting a summer job, and breaking up with a girl/boy friend. Two variables comprised a stepwise logistic regression model designed to differentiate injured from ill adolescents: male sex and life-event score. We conclude that adolescent boys with recent stressful events may be at high risk for unintentional injury.

Adolescent↗

PubMed1989

Risk factors for attempted suicide during adolescence.

It is unknown whether adolescents can provide the information necessary to identify their risk for attempted suicide. The present study was designed to determine whether data collected directly from adolescents can be used to develop a simple model for differentiating suicidal from nonsuicidal adolescents. Patients aged 13 to 19 years hospitalized for medical complications of serious suicide attempts (n = 56) or for acute illnesses unrelated to injuries or ingestions (n = 248) completed self-administered questionnaires pertaining to psychosocial function, recent stress, alcohol and drug use, and health care use. Compared with ill adolescents, suicidal adolescents had poorer mental health, impulse control, family relationships, and school performance; higher 3-month stress scores and alcohol-use scores; and more use of 7 of 12 drugs (P less than .05). Compared with ill adolescents, suicidal adolescents were more likely to report previous suicide attempts (39% vs 10%, P less than .001) and previous mental health care (27% vs 8%, P less than .001) but were less likely to identify a primary care site (61% vs 87%, P less than .001). In a logistic regression model based on previous suicide attempts, previous mental health care, poor school performance, marijuana use, and dependence on the emergency room for primary care, 84% of the suicidal and 55% of the ill adolescents were correctly identified. If validated prospectively, these five self-administered questions may constitute a helpful screen for the rapid identification of suicidal adolescents.

Adolescent↗