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How do you approach the psychiatric evaluation and disposition of adolescents presenting after an overdose that was not a suicide attempt?

How do you approach the psychiatric evaluation and disposition of adolescents presenting after an overdose that they say was not a suicide attempt? What factors raise concern for underlying suicide risk despite reported non-suicidal intent? When do you recommend psychiatric admission versus outpatient management?
3 Answers
Mednet Member
Mednet MemberInvited Expert
Psychiatry · Childrens Hospital Colorado
Answered on

There is much to learn.

  1. If previous history of SIB, OD-likely admit.
  2. Known psychiatric disorder - perhaps IOP/PHP.
  3. What triggered the OD? For instance, breakup, argument - perhaps IOP/PHP.
  4. Recent traumatic event - perhaps IOP/PHP
  5. Family functioning: Is the family supportive, dismissive, chaotic, or...

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Mednet Member
Mednet MemberInvited Expert
Psychiatry · Siu Psychiatry
Answered on

I agree with the answer given by Dr. @Dr. First Last. Per my experience, most teenagers who are severely depressed will deny or minimize their suicide attempt for multiple reasons. This is like how a patient with an eating disorder won't admit to their symptoms. The disposition may not be straightfo...

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Mednet Member
Mednet Member
Psychiatry · Rancho Cucamonga
Answered on

Agree with previous statements.

High-risk features that would support admission:

  • Previous attempts
  • Alcohol or drug use
  • Other associated diagnoses, including personality disorders
  • Eating disorders
  • Psychotic features

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