Does a copycat effect exist in the emergency department?

Abstract

Objective: This study aimed to examine the copycat effect of a famous actress's suicide on suicide attempts visiting the emergency department (ED) in Korea. Method: We retrospectively reviewed the medical records of suicide attempt cases which had visited the EDs of two general hospitals during the 6 months before and after a celebrity suicide. We obtained data pertaining to demographics, history of psychiatric illnesses and suicide attempts, method of the suicide attempts, discharge status, and follow-up compliance. Results: We identified 319 cases during the study period, of which 158 cases occurred before the celebrity suicide, and 161 occurred after the event. Following the celebrity suicide, suicide attempts with the similar age and the same method as the celebrity's suicide (hanging), presence of psychiatric history, and use of intensive and multiple methods increased. We observed that suicide attempts with the similar age and the same method of hanging were consistent with a copycat effect. Despite a decrease of discharge against advice (DAA) after the celebrity's death from 67.7% to 59.6%, DAA was still high, and the follow-up compliance at outpatient clinics was less than 50%. Conclusions: A copycat effect was found in ED-visiting suicide attempts. Prevention of re-attempts should be initiated in the ED. A specific action guide should be established for suicide attempts in the ED, including cooperation between other hospitals, the community, and the media.