Evaluation of the association between bilateral calcaneal fractures and suicide attempts: Findings from 4 different trauma centers in Turkey

Yıl 2021, Cilt: 38 Sayı: 3, 221 - 226, 01.05.2021

Emre Gültaç , Ahmet Acan , Cem Yalın Kılınç , Nermin Gündüz , Nihat Demirhan Demirkıran , Mehmet Yücens , Nevres Aydoğan

Öz

Background: We aimed to to determine the association between bilateral calcaneal fractures and suicide attempt and some socio-demographic characteristics.
Methods: This study was conducted among patients admitted to the emergency departments of four trauma centers with bilateral calcaneal fractures between January 2014 and March 2017. The Sociodemographic Data Form, Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders fourth edition (DSM-IV) and Axis I Disorders (SCID-I) were applied to participants. Comparisons about age and gender was made between suicidal and non-suicidal patiens with bilateral calcaneal fractures.
Results: Twenty-three patients with bilateral calcaneus fractures were included in the study. Of the 23 patients with bilateral calcaneal fractures, 14 (61%) were evaluated as suicidal and 9 (39%) were evaluated as not suicidal. The majority of suicidal jumpers were female (n = 11, 78.6%). Suicidal patients were younger compared with non-suicidal fallers. As a result of SCID I interview, 9 (64.3%) of 14 suicidal jumpers were diagnosed with serious psychiatric diagnoses: One patient was diagnosed with first episode psychotic disorder, one with schizophrenia, one with Schizoaffective Disorder, one with Bipolar Disorder, two with Major Depressive Disorder and three with Adjustment Disorder.
Conclusion: Based on our study results we determined that suicidal jumpers are frequently diagnosed with serious psychiatric disorders. Therefore, the psychiatric dimension should be taken into consideration in the treatment plan for patients with bilateral calcaneal fractures and the multidisciplinary approach should be taken.

Anahtar Kelimeler

bilateral calcaneus fractures, suicidal high falls, suicide attempts

Kaynakça

• Reference 1. American Foundation for Suicide Prevention (AFSP). Suicide statistics. [webpage]. 2018. https://afsp.org/about-suicide/suicide-statistics/. Accepted at:07.08.2018
• Reference 2. American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders, fourth ed. Washington, DC: American Psychiatric Association, 1994.
• Reference 3. Beale JP, Wyatt JP, Beard D, Busuttil A, Graham CA. A five year study of high falls in Edinburgh. Injury 2000;31(7): 503-8.
• Reference 4. Bennewith O, Nowers M, Gunnell D. Effect of barriers on the Clifton suspension bridge, England, on local patterns of suicide: implications for prevention. Br J Psychiatry 2007;190: 266-7.
• Reference 5. Çorapçıoğlu A, Aydemir Ö, Yıldız M, Danacı AE, Köroğlu E. DSM-IV Eksen-I Bozuklukları için Yapılandırılmış Klinik Görüşme. Ankara: Hekimler Yayın Birliği, 1999
• Reference 6. Daftary A, Haims AH, Baumgaertner MR. Fractures of the calcaneus: a review with emphasis on CT. Radiographics 2005;25(5):1215-26.
• Reference 7. de Moore GM, Robertson AR. Suicide attempts by firearms and by leaping from heights: a comparative study of survivors. Am J Psychiatry 1999;156(9): 1425-31.
• Reference 8. de Pourtalès MA, Hazen C, Cottencin O, Consoli SM. Adolescence, substance abuse and suicide attempt by jumping from a window. Presse Med 2010;39(2):177-86.
• Reference 9. Gore-Jones V, O’Callaghan J. Suicide attempts by jumping from a height: a consultation liaison experience. Australas Psychiatry 2012;20(4):309-12.
• Reference 10. Gunnell D, Nowers M. Suicide by jumping. Acta Psychiatr Scand 1997;96(1):1-6.
• Reference 11. Hahn MP, Richter D, Ostermann PA, Muhr G. Injury pattern after fall from great height. An analysis of 101 cases. Unfallchirurg 1995;98(12): 609-13.
• Reference 12. Hawton K, Fagg J. Suicide and other causes of death, following attempted suicide. The British Journal of Psychiatry1988;152(3):359-66.
• Reference 13. Katz K, Gonen N. Goldberg I, Mizrahi J, Radwan M, Yosipovitch Z. Injuries in attempted suicide by jumping from a height. Injury 1988;19(6):371-4.
• Reference 14. Kontaxakis V, Markidis M, Vaslamatzis G, Ioannidis H, Stefanis C. Attempted suicide by jumping: clinical and social features. Acta Psychiatr Scand 1988;77(4): 435-7.
• Reference 15. Li L, Smialek JE. The investigation of fatal falls and jumps from heights in Maryland (1987-1992). Am J Forensic Med Pathol 1994;15(4): 295-9.
• Reference 16. Mcbride DJ RC, Laing P. The hindfoot: calcaneal and talar fractures and dislocations-Part I: Fractures of the calcaneum. Curr Orthop 2005;19:94-100.
• Reference 17. Mitchell MJ, McKinley JC, Robinson CM. The epidemiology of calcaneal fractures. Foot (Edinb) 2009;19(4):197-200.
• Reference 18. Nielssen O, Glozier N, Babidge N, Reutens S, Andrews D, Gerard A, et al. Suicide attempts by jumping and psychotic illness. Aust N Z J Psychiatry 2010;44(6): 568-73.
• Reference 19. Reynolds BM, Balsano NA, Reynolds FX. Falls from heights: a surgical experiences of 200 consecutive cases. Ann Surg 1971;174(2):304-8.
• Reference 20. Richter D, Hahn MP, Ostermann PA, Ekkernkamp A, Muhr G. Vertical deceleration injuries: a comparative study of the injury patterns of 101 patients after accidental and intentional high falls. Injury 1996; 27(9): 655-9.
• Reference 21. Rocos B, Acharya M, Chesser TJ. The Pattern of Injury and Workload Associated with Managing Patients After Suicide Attempt by Jumping from a Height. Open Orthop J 2015;9: 395-8.
• Reference 22. Rocos B, Chesser TJ, Injuries in jumpers - are there any patterns?, World J Orthop 2016;7(3): 182-7.
• Reference 23. Small GW, Rosenbaum JF. Nine psychiatric inpatients who leaped from a height. Can J Psychiatry 1984;29(2): 129-31
• Reference 24. Spitzer RL, Williams JB, Gibbon M, First MB. The Structured Clinical Interview for DSM-IV Axis I Disorders, Clinician Version (SCID-CV). Washington: American Psychiatric Press Inc.; 1996.
• Reference 25. Suokas J, Suominen K, İsometsa E, Ostamo A, Lonnqvist J. Long-term risk factors for suicide mortality after attempted suicide findings of a 14 year follow-up study. Acta Psychiatr Scand 2001;104:117-21.
• Reference 26. Teh J, Fırth M, Sharma A, Wılson A, Reznek R, Chan O. Jumpers and fallers: a comparison of the distribution of skeletal injury. Clinical Radiology 2003;58(6):482-6.
• Reference 27. Värnik A, Kõlves K, Allik J, Arensman E, Aromaa E, van Audenhove C, et al. Gender issues in suicide rates, trends and methods among youths aged 15-24 in 15 European countries. J Affect Disord 2009;113(3): 216-226.
• Reference 28. Värnik A, Kõlves K, van der Feltz-Cornelis CM, Marusic A, Oskarsson H, Palmer A, et al. Suicide methods in Europe: a gender-specific analysis of countries participating in the “European Alliance Against Depression”. J Epidemiol Community Health 2008;62(6): 545-51.
• Reference 29. Wasserman D, Rihmer Z, Rujescu D, Sarchiapone M, Sokolowski M, Titelman D, et al. The European Psychiatric Association (EPA) guidance on suicide treatment and prevention. Eur Psychiatry 2012;27(2): 129–41.
• Reference 30. Weber AN, Michail M, Thompson A, Fiedorowicz JG. Psychiatric Emergencies: Assessing and Managing Suicidal Ideation. Med Clin North Am 2017;101(3): 553–71.
• Reference 31. Wirbel RJ, Olinger A, Karst M, Mutschler WE. Treatment of severe injuries caused by attempted suicide: pattern of injury and influence of the psychiatric disorder on the postoperative course. Eur J Surg 1998;164(2): 109–13.