Timing of suicide attempts by children and adolescents admitted to an inpatient psychiatry unit: a retrospective study

Abstract

Abstract Background Suicide is a leading cause of death in adolescents in Canada and has been documented to occur mainly during evening hours. It is suspected to be due to the accumulation of waking hours combined with sleep disturbances causing poor decision making. Identifying modifiable factors associated with suicide risk remains an important part of suicide prevention. Aims To examine the timing of suicide attempts in adolescents admitted to a pediatric hospital following a suicide attempt and known to present sleep disturbances, to further strengthen the relationship between sleep disturbance and suicidality and its chronobiological manifestation. Method Descriptive retrospective study of patients < 18 years (N = 128) admitted to a tertiary care hospital for a suicide attempt between January 1, 2022, to June 30, 2023. Results As expected, a higher percentage of attempts occurred between 18:00–23:59, as compared to other time periods (p < 0.001), with peak days Sunday and Monday, for the 18:00–23:59 group. Time of day was not found to differ by gender (p = 0.45) nor was weekday/weekend (p = 0.48). The most common method of attempt was ingestion. Limitations Small sample limited to hospitalized patients and retrospective design. Conclusion The observation that this group of suicidal adolescents is known to present sleep disruptions offers an additional prevention opportunity. Knowledge of the presence of sleep disturbances and the peak time of suicide attempts could help in suicide prevention efforts. Future exploration of the evening phenomenological experience of this population to develop interventions for parents, community resources, pharmacies, and schools to further detect risk factors in adolescent suicidality.