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Geith S, Lumpe M, Schurr J, Schmoll S, Rabe C, Ott A, Stich R, Rentrop M, Eyer F, Zellner T. Clinical course and demographic insights into suicide by self-poisoning: patterns of substance use and socio-economic factors. Soc Psychiatry Psychiatr Epidemiol 2024:10.1007/s00127-024-02750-x. [PMID: 39317728 DOI: 10.1007/s00127-024-02750-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/04/2024] [Accepted: 08/15/2024] [Indexed: 09/26/2024]
Abstract
PURPOSE To analyze whether sociodemographic characteristics influence the substance choice and preclinical and clinical course of suicidal poisoning. METHODS This was a retrospective single-center study in patients hospitalized due to suicidal poisoning and who received at least one psychiatric exploration during their inpatient stay. Patients' sociodemographic, anamnestic, preclinical, and clinical parameters were analyzed with respect to sex and age. RESULTS 1090 patients were included, 727 (67%) were females, median age was 39 years (min-max: 13-91) with 603 (55%) aged 18-44 years. 595 patients (54.8%) ingested a single substance for self-poisoning, 609 (59.5%) used their own long-term medication. Comparing to males, females preferred antidepressants (n = 223, 30.7%, vs n = 85, 23.4%; p = 0.013) and benzodiazepines (n = 202, 27.8%, vs n = 65, 17.9%; p < 0.001); males more often used cardiovascular drugs (n = 33, 9.1%, vs n = 34, 4.7%; p = 0.005) and carbon monoxide (n = 18, 5.0%, vs n = 2, 0.3%; p < 0.001). Use of Z-drugs (n = 1, 1.7%, to n = 37, 33.3%; p < 0.001) and benzodiazepines (n = 4, 6.9%, to n = 33, 29.7%; p = 0.003) increased with age (< 18 to > 64 years), while use of non-opioid analgesics (n = 23, 39.7%, to n = 20, 18.0%; p < 0.001) decreased. Average dose of substance in patients > 64 years was 12.9 ± 18.4 times higher than recommended maximum daily dose (compared to 8.7 ± 15.2 higher in those aged < 18 years; p < 0.001). Males more often required intensive care (n = 150, 41.3%, vs n = 205 females, 28.2%; p < 0.001). CONCLUSION These results underline the complexity of (para-)suicidal poisonings and identify potential measures for their prevention, such as restricting access and better oversight over the use of certain substances.
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Affiliation(s)
- Stefanie Geith
- Department of Clinical Toxicology, Klinikum Rechts der Isar, TUM School of Medicine and Health, Technical University of Munich, Ismaninger Str. 22, 81675, Munich, Germany.
| | - Maja Lumpe
- Department of Clinical Toxicology, Klinikum Rechts der Isar, TUM School of Medicine and Health, Technical University of Munich, Ismaninger Str. 22, 81675, Munich, Germany
| | - Johannes Schurr
- Department of Clinical Toxicology, Klinikum Rechts der Isar, TUM School of Medicine and Health, Technical University of Munich, Ismaninger Str. 22, 81675, Munich, Germany
| | - Sabrina Schmoll
- Department of Clinical Toxicology, Klinikum Rechts der Isar, TUM School of Medicine and Health, Technical University of Munich, Ismaninger Str. 22, 81675, Munich, Germany
| | - Christian Rabe
- Department of Clinical Toxicology, Klinikum Rechts der Isar, TUM School of Medicine and Health, Technical University of Munich, Ismaninger Str. 22, 81675, Munich, Germany
| | | | - Raphael Stich
- Department of Clinical Toxicology, Klinikum Rechts der Isar, TUM School of Medicine and Health, Technical University of Munich, Ismaninger Str. 22, 81675, Munich, Germany
| | - Michael Rentrop
- Clinic and Policlinic for Psychiatry and Psychotherapy, Klinikum Rechts der Isar, Technical University of Munich, Munich, Germany
- kbo-Inn-Salzach Clinic, Wasserburg am Inn, Germany
| | - Florian Eyer
- Department of Clinical Toxicology, Klinikum Rechts der Isar, TUM School of Medicine and Health, Technical University of Munich, Ismaninger Str. 22, 81675, Munich, Germany
| | - Tobias Zellner
- Department of Clinical Toxicology, Klinikum Rechts der Isar, TUM School of Medicine and Health, Technical University of Munich, Ismaninger Str. 22, 81675, Munich, Germany
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Predescu E, Calugar I, Bibu-Monus C, Sipos R. Trends and Prevalence of Hospital Admissions Related to Deliberate Self-Poisoning and Used Substances in Romanian Adolescents between 2016 and 2022. CHILDREN (BASEL, SWITZERLAND) 2023; 10:children10050790. [PMID: 37238338 DOI: 10.3390/children10050790] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/19/2023] [Revised: 04/24/2023] [Accepted: 04/26/2023] [Indexed: 05/28/2023]
Abstract
Rates of self-poisoning are increasing substantially all around the world, with self-poisoning being the most common form of self-harm leading to hospitalization in children and adolescents. This study aims to investigate the trends in the number of deliberate self-poisoning admissions in Romanian adolescents during the period of 2016-2022, as well as the most frequently used substances and the impact of the COVID-19 pandemic on hospital admissions due to self-poisoning and substance use in relation to these episodes. The sample included 178 patients admitted to the Clinic of Pediatric Psychiatry in Cluj-Napoca from 2016 to 2022 due to an episode of self-poisoning. Data were collected on patients' sociodemographic characteristics, psychosocial characteristics, and medical histories. We report a slight overall increase in the self-poisoning admission rate during the studied period. There was a decrease during the initial period of the pandemic, with significantly increasing rates in the second year of the pandemic. The mean prevalence rate of hospital admissions due to self-poisoning episodes during the study period was 3.14% (95% CI 2.72, 3.63). Adolescent girls were identified as the most vulnerable group, with the female-to-male ratio increasing dramatically. In terms of substance use, benzodiazepines; over-the-counter analgesics, including paracetamol; and antidepressants were the most frequently used substances. We emphasize the importance of careful consideration in prescribing psychotropic drugs, as well as the need for regulation of over-the-counter drug dispensation.
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Affiliation(s)
- Elena Predescu
- Department of Neuroscience, Psychiatry and Pediatric Psychiatry, "IuliuHatieganu" University of Medicine and Pharmacy, 400489 Cluj-Napoca, Romania
| | - Iulia Calugar
- Clinic of Pediatric Psychiatry and Addiction, Clinical Emergency Hospital for Children, 400489 Cluj-Napoca, Romania
| | - Cristian Bibu-Monus
- 1st Surgical Clinic, Emergency Clinical County Hospital Cluj, 400006 Cluj-Napoca, Romania
| | - Roxana Sipos
- Department of Neuroscience, Psychiatry and Pediatric Psychiatry, "IuliuHatieganu" University of Medicine and Pharmacy, 400489 Cluj-Napoca, Romania
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Kasemy ZA, Sharif AF, Amin SA, Fayed MM, Desouky DE, Salama AA, Abo Shereda HM, Abdel-Aaty NB. Trend and epidemiology of suicide attempts by self-poisoning among Egyptians. PLoS One 2022; 17:e0270026. [PMID: 35709176 PMCID: PMC9202942 DOI: 10.1371/journal.pone.0270026] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2020] [Accepted: 06/02/2022] [Indexed: 11/19/2022] Open
Abstract
Suicide attempts by self-poisoning have become a critical health problem. This study aimed to investigate the trend, incidence, and the associated risk factors of suicide attempts by self-poisoning. A total of 7398 Egyptian patients were analyzed. The trend of suicide attempts by self-poisoning was analyzed using 6745 patients over four registry years from January 1, 2016, to January 1, 2020. Then, the associated risk factors behind attempted suicide by self-poisoning from January 1, 2019, to January 1, 2020, were assessed using 2523 suicide attempters by self-poisoning, 201 fatalities by self-poisoning, and another 653 survivors of accidental poisoning. Results showed a rising trend of suicide attempts by self-poisoning over the studied years. The incidence of suicide attempts through deliberate self-poisoning represented 26.63/1,000 (CI95%: 25.63-27.86) to the admitted patients and 26.10/100,000 (CI95%: 25.10-27.14) to the regional population. The death rate due to suicide attempts by self-poisoning was 2.08/100,000 (1.90-2.49). The case fatality rate and the proportionate mortality rate for suicide by self-poisoning were 7.38% (CI95%: 6.45-8.42) and 14.11% (CI95%: 12.4-16.0) respectively. Multivariate analysis revealed that attempted suicide by self-poisoning was predicted among patients aged <25 or 25-40 years old (OR = 27.49, CI95%: 15.28-49.64 and OR = 59.42, CI95%: 32.76-107.77 respectively), those of low or moderate socioeconomic status (OR = 35.03, CI95%: 21.32-57.56 and OR = 14.11, CI95%: 10.86-18.43 respectively), students (OR = 2.91, CI95%: 1.57-5.43) and those living in rural residency (OR = 4.12, CI95%: 3.27-5.19). Suicide attempts by self-poisoning exhibited an incremental rise across time which raises a serious concern. Efforts should be directed to overcome the mentioned risk factors triggering suicide attempts by self-poisoning.
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Affiliation(s)
- Zeinab A. Kasemy
- Department of Public Health and Community Medicine, Faculty of Medicine, Menoufia University, Menoufia, Egypt
| | - Asmaa Fady Sharif
- Department of Forensic Medicine and Clinical Toxicology, Faculty of Medicine, Tanta University, Tanta, Egypt
- Department of Clinical Sciences, College of Medicine, Dar Al Uloom University, Riyadh, Saudi Arabia
| | - Safaa Abdelzaher Amin
- Department of Forensic medicine and clinical toxicology, Faculty of Medicine, Menoufia University, Menoufia, Egypt
| | - Manar Maher Fayed
- Department of Forensic Medicine and Clinical Toxicology, Faculty of Medicine, Tanta University, Tanta, Egypt
| | - Dalia E. Desouky
- Department of Public Health and Community Medicine, Faculty of Medicine, Menoufia University, Menoufia, Egypt
| | - Amal A. Salama
- Department of Family medicine, Faculty of Medicine, Menoufia University, Menoufia, Egypt
| | - Hanaa Mohammad Abo Shereda
- Department of Psychiatric and Mental Health Nursing, Faculty of Nursing, Menoufia University, Menoufia, Egypt
| | - Nehad B. Abdel-Aaty
- Department of Public Health and Community Medicine, Faculty of Medicine, Menoufia University, Menoufia, Egypt
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Cairns R, Karanges EA, Wong A, Brown JA, Robinson J, Pearson SA, Dawson AH, Buckley NA. Trends in self-poisoning and psychotropic drug use in people aged 5-19 years: a population-based retrospective cohort study in Australia. BMJ Open 2019; 9:e026001. [PMID: 30787095 PMCID: PMC6398641 DOI: 10.1136/bmjopen-2018-026001] [Citation(s) in RCA: 43] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
OBJECTIVES To characterise trends in self-poisoning and psychotropic medicine use in young Australians. DESIGN Population-based retrospective cohort study. SETTING Calls taken by the New South Wales and Victorian Poisons Information Centres (2006-2016, accounting for 70% of Australian poisoning calls); medicine dispensings in the 10% sample of Australian Pharmaceutical Benefits Scheme data (July 2012 to June 2016). PARTICIPANTS People aged 5-19 years. MAIN OUTCOME MEASURES Yearly trends in intentional poisoning exposure calls, substances taken in intentional poisonings, a prevalence of psychotropic use (dispensing of antidepressants, antipsychotics, benzodiazepines and medicines for attention deficit hyperactivity disorder (ADHD)). RESULTS There were 33 501 intentional poisonings in people aged 5-19 years, with an increase of 8.39% per year (95% CI 6.08% to 10.74%, p<0.0001), with a 98% increase overall, 2006-2016. This effect was driven by increased poisonings in those born after 1997, suggesting a birth cohort effect. Females outnumbered males 3:1. Substances most commonly taken in self-poisonings were paracetamol, ibuprofen, fluoxetine, ethanol, quetiapine, paracetamol/opioid combinations, sertraline and escitalopram. Psychotropic dispensing also increased, with selective serotonin reuptake inhibitors (SSRIs) increasing 40% and 35% July 2012 to June 2016 in those aged 5-14 and 15-19, respectively. Fluoxetine was the most dispensed SSRI. Antipsychotics increased by 13% and 10%, while ADHD medication dispensing increased by 16% and 10%, in those aged 5-14 and 15-19, respectively. Conversely, dispensing of benzodiazepines to these age groups decreased by 4% and 5%, respectively. CONCLUSIONS Our results signal a generation that is increasingly engaging in self-harm and is increasingly prescribed psychotropic medications. These findings indicate growing mental distress in this cohort. Since people who self-harm are at increased risk of suicide later in life, these results may foretell future increases in suicide rates in Australia.
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Affiliation(s)
- Rose Cairns
- NSW Poisons Information Centre, The Children’s Hospital at Westmead, Sydney, New South Wales, Australia
- Sydney Pharmacy School, The University of Sydney, Sydney, New South Wales, Australia
| | - Emily A Karanges
- Centre for Big Data Research in Health, University of New South Wales, Sydney, New South Wales, Australia
| | - Anselm Wong
- Victorian Poisons Information Centre and Austin Toxicology Service, Austin Health, Heidelberg, Victoria, Australia
| | - Jared A Brown
- NSW Poisons Information Centre, The Children’s Hospital at Westmead, Sydney, New South Wales, Australia
| | - Jeff Robinson
- Victorian Poisons Information Centre, Austin Health, Heidelberg, Victoria, Australia
| | - Sallie-Anne Pearson
- Centre for Big Data Research in Health, University of New South Wales, Sydney, New South Wales, Australia
| | - Andrew H Dawson
- NSW Poisons Information Centre, The Children’s Hospital at Westmead, Sydney, New South Wales, Australia
- Central Clinical School, The University of Sydney, Sydney, New South Wales, Australia
| | - Nicholas A Buckley
- NSW Poisons Information Centre, The Children’s Hospital at Westmead, Sydney, New South Wales, Australia
- Pharmacology, University of Sydney, Sydney, New South Wales, Australia
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