New research out of Spain highlights the fragility of care for kids at risk of suicide, while a pair of case studies shed some light on veterinary-grade adenosine monophosphate and factitious disorder.
At-Risk Kids Keep Returning to the ED
A quarter of children and adolescents who show up at the emergency department for suicidal thoughts or behaviors return within six months. A new Spanish study reinforces just how fragile post-crisis care remains for at-risk kids.
The study, appearing this week in The Journal of Clinical Psychiatry, followed more than 700 patients who visited a child and adolescent psychiatric ED in Madrid between early 2022 and late 2023. Among them, 429 presented with self-injurious thoughts and behaviors, including suicidal ideation, suicide attempts, or nonsuicidal self-injury. Within six months, more than 25% of them returned to the ED because of renewed suicidal concerns.
Patients returned to the emergency department at elevated rates despite how they first presented. Roughly one in four youth who first came in for suicidal ideation or a suicide attempt revisited the ED. And more than one in five who presented with nonsuicidal self-injury returned. Some patients also escalated from ideation to attempts, highlighting the fluid and unpredictable nature of suicidal crises in adolescents.
After accounting for several clinical and social factors, two indicators loomed large.
- Young people with a history of suicidal behavior were more than twice as likely to return to the ED.
- Nonheterosexual sexual orientation independently predicted repeat visits. The finding highlights the added burden of stigma, stress, and social vulnerability faced by sexual minority youth.
The authors argue that ED visits should serve as a launching point for sustained, coordinated follow-up. Without stronger continuity of care, they warn, many adolescents remain caught in a revolving door of emergency treatment.
IN OTHER PSYCHIATRY AND NEUROLOGY NEWS
- A new case report in The Primary Care Companion for CNS Disorders describes how unsupervised intravenous use of veterinary-grade adenosine monophosphate led to severe stimulant-like dependence, withdrawal, and psychiatric symptoms.
- A new JCP analysis argues that a subtle chemical tweak to the antipsychotic amisulpride could produce a safer, more effective next-generation treatment.
- Another PCC case report shows how coordinated, nonconfrontational primary care follow-up can rein in factitious disorder, cutting emergency visits and stabilizing care.
- In a letter to the editor of JCP, a reader argues that clozapine remains unjustly sidelined in U.S. psychiatry and urges clinicians to give more patients a fair trial of the drug.
- And in breaking news this week, the FDA has granted priority review to Otsuka’s centanafadine, a first-in-class ADHD drug candidate for children, adolescents, and adults.
