1.Adolescent self-harm and suicide attempts: An analysis of emergency department presentations in Singapore.
Darren Kai Siang CHONG ; Vicknesan Jeyan MARIMUTTU ; Pei Shan HOE ; Chu Shan Elaine CHEW ; Angelina Su Yin ANG
Annals of the Academy of Medicine, Singapore 2025;54(2):78-86
INTRODUCTION:
The rising rate of adolescent suicide, and the burden of self-harm and mental health disorders, pose significant threats to Singapore's future health outcomes and human potential. This study sought to examine the risk profile and healthcare utilisation patterns of Singaporean adolescents who presented to the emergency department (ED) for suicidal or self-harm behaviour.
METHOD:
A retrospective review of medical records for patients aged 10 to 19 years who visited Singapore's KK Women's and Children's Hospital ED for suicidal or self-harm attempts from January to December 2021 was conducted.
RESULTS:
A total of 221 patients were identified, with a predominance of female patients (85.5%) over males (14.5%). The mean age was 14.2 ± 1.4 years. Intentional drug overdose (52.0%) was the most commonly used method. Significantly more females presented for intentional paracetamol overdose (46.6% versus [vs] 28.1%, P=0.049), whereas jumping from a height was more common among males (18.8% vs 5.8%, P=0.022). The most frequently observed mental health challenges were stress-related and emotional coping difficulties (50.7%), followed by mood and anxiety symptoms (53.4%). A history of self-harm and suicidal behaviours were the most common psychosocial risk factors. Within the year prior to their ED presentation, 15.4% had accessed healthcare services for mild medical ailments, 19.5% for medically unexplained symptoms, and 17.2% for previous self-harm or suicide attempts.
CONCLUSION
Most cases involved psychosocial and emotional regulation difficulties, some of which displayed sex-specific patterns, rather than complex psychiatric disorders. The identified predictive factors can help inform Singapore's National Mental Health and Well-being Strategy, to guide targeted and transdiagnostic interventions in schools and community settings.
Humans
;
Adolescent
;
Singapore/epidemiology*
;
Female
;
Male
;
Suicide, Attempted/psychology*
;
Emergency Service, Hospital/statistics & numerical data*
;
Self-Injurious Behavior/psychology*
;
Retrospective Studies
;
Child
;
Young Adult
;
Drug Overdose/epidemiology*
;
Risk Factors
;
Acetaminophen/poisoning*
;
Patient Acceptance of Health Care/statistics & numerical data*
;
Sex Factors
3.Evaluation of a group family-based intervention programme for adolescent obesity: the LITE randomised controlled pilot trial.
Chu Shan Elaine CHEW ; Jean Yin OH ; Kumudhini RAJASEGARAN ; Seyed Ehsan SAFFARI ; Chee Ming Micheal LIM ; Siew Choo LIM ; Shiling TAN ; Siobhan KELLY
Singapore medical journal 2021;62(1):39-47
INTRODUCTION:
This study aimed to evaluate the LITE (Lifestyle Intervention for TEenagers) group programme, a family-based behavioural lifestyle intervention for overweight and obese adolescents.
METHODS:
We conducted a two-arm randomised controlled trial that recruited overweight and obese adolescents who attended a tertiary care weight management clinic. Participants were randomised to the LITE programme or usual care. The primary outcome assessed was body mass index (BMI) z-score. Secondary outcomes of anthropometric measurements, metabolic profile, parenting and adolescents' perception of family support were measured at baseline, three months and six months. Feasibility and acceptability of the LITE programme were also evaluated.
RESULTS:
61 adolescents were enrolled, with 31 in the LITE programme and 30 in usual care. At three months, participants in the programme had a greater reduction in weight (-0.18 ± 2.40 kg vs. 1.48 ± 1.97 kg; p = 0.107), waist circumference (-1.0 ± 3.1 cm vs. 2.4 ± 2.7 cm; p = 0.016), waist-height ratio (-0.01 ± 0.02 vs. 0.01 ± 0.02; p = 0.040) and systolic blood pressure (-3.8 ± 13.7 vs. 5.7 ± 13.1; p = 0.119) compared to the usual care group. There was no significant difference in BMI z-score. At six months, there were significant improvements in adolescents' perception of family support for eating habits in the LITE group compared to the usual care group. The LITE programme had a good attendance rate of 67.7% and was well received.
CONCLUSION
The LITE programme showed feasibility and short-term clinical effectiveness in improving some clinical outcomes and improved adolescents' perception of family support.

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