Admission to intensive care for parasuicide by self-poisoning: Variation by time cycles, climate and the lunar cycle

Eisenbach, Christoph; Ungur, Alexander Lavinius; Unger, Joerg; Stremmel, Wolfgang; Encke, Jens

doi:10.1016/j.psychres.2007.09.008

Cited by 14 publications

(7 citation statements)

References 55 publications

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“…The peak in deliberate self-harm on Mondays is a persistent one previously observed in the U.S. with 1973–85 mortality data (McCleary, Chew, Hellsten, & Flynn-Bransford, 1991) and with data from around the world (Polewka, et al, 2004; Eisenbach, Ungur, Unger, Stremmel, & Encke, 2008; Ho, et al, 1998; Nishi, Miyake, Okamoto, Goto, & Sakai, 2000; Durkheim, 1897). Like our study, Bradvick & Berglund (2003) and Erazo, Baumert, Ladwig (2004) also find that the rate of deliberate self-harm is significantly elevated on Tuesdays.…”

Section: Discussionsupporting

confidence: 57%

Suicide Deaths and Nonfatal Hospital Admissions for Deliberate Self-Harm in the United States

Miller

Furr‐Holden

Lawrence

et al. 2012

Crisis

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Background No one knows if the temporality of non-fatal deliberate self-harm in the United States (U.S.) mirrors the temporality of suicide deaths. Aims To analyze day- and month-specific variation in population rates for suicide fatalities and, separately, for hospital admissions for non-fatal deliberate self-harm. Methods For 12 states, we extracted vital statistics data on all suicides (n=11,429) and hospital discharge data on all non-fatal deliberate self-harm admissions (n=60,870) occurring in 1997. We used multinomial logistic regression to analyze the significance of day-to-day and month-to-month variations in occurrence of suicides and non-fatal deliberate self-harm admissions. Results Both fatal and nonfatal events had a 6%–10% excess occurrence on Monday and Tuesday and were 5%–13% less likely to occur on Saturdays (p<0.05). Males were more likely than females to act on Wednesdays and Saturdays. Non-fatal admission rates were 6% above the average in April and May (p<0.05). In contrast, suicide rates were 6% above the average in February and March and 8% below it in November (p<0.05). Conclusions Suicides and non-fatal hospital admissions for deliberate self-harm have peaks and troughs on the same days in the U.S. In contrast, the monthly patterns for these fatal and non-fatal events are not congruent.

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Section: Discussionsupporting

confidence: 57%

Suicide Deaths and Nonfatal Hospital Admissions for Deliberate Self-Harm in the United States

Miller

Furr‐Holden

Lawrence

et al. 2012

Crisis

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“…The frequency of parasuicides was associated with "bad weather". No association of parasuicide incidences to the lunar cycle was observed [10]. In another investigation by Buckley and colleagues similar results were presented after analysis of 2215 patients after selfpoisoning with a marked circadian variation with over 6% of all admissions occurring in each of the hours between 6 p.m. and 1 a.m. compared with less than 2% per hour between 5 a.m. and 9 a.m. [11] The results of our study are in line with investigations derived from other medical fields (mostly intensive care units) such as a large study by Arulkumaran et al prospectively investigating a study cohort of 195′428 unplanned admissions from 212 adult general critical care units in England, Wales and Northern Ireland during a 3 year's period without detecting significant influences on patient mortality for unplanned admissions to adult general critical care units within the United Kingdom [12].…”

Section: Discussionmentioning

confidence: 81%

“…Eisenbach and colleagues [10] investigated patients after self-poisoning with suicidal intents during the years 2002 and 2004 in a cohort of 691 individuals and found a peak before midnight concerning the admissions. Variation with the day of the week was less clear in this investigation showing a peak incidence on Mondays without significant variations with monthly or annual cycles.…”

Section: Discussionmentioning

confidence: 99%

Limited predictive value of admission time in clinical psychiatry

Kreuzer

Günther

Simões

et al. 2020

BMC Health Serv Res

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Background A large proportion of admissions to psychiatric hospitals happen as emergency admissions and many of them occur out of core working hours (during the weekends, on public holidays and during night time). However, very little is known about what determines admission times and whether the information of admission time bears any relevance for the clinical course of the patients. In other words, do admission times correlate with diagnostic groups? Can accumulations of crises be detected regarding circadian or weekly rhythms? Can any differences between workdays and weekends/public holidays be detected? May it even be possible to use information on admission times as a predictor for clinical relevance and severity of the presented condition measured by the length of stay? Methods In the present manuscript we analyzed data derived from 37′705 admissions to the Psychiatric District Hospital of Regensburg located in the Southern part of Germany covering the years 2013 to 2018 with regard to ICD-10 diagnostic groups and admission times. The hospital provides 475 beds for in-patient treatment in all fields of clinical psychiatry including geriatrics and addiction medicine. Results Several core questions could be answered based on our analysis: 1st Our analysis confirms that there is a high percentage of unheralded admissions out of core time showing broad variation. 2nd In contrary to many psychiatrists’ misconceptions the time of admission has no relevant impact on the length of stay in the hospital. 3rd The predictive value of admission time regarding the allocation to ICD-10 diagnostic groups is low explaining only 1% of variability. Conclusions Taken together, our data reveal the enormous variation of admission times of psychiatric patients accounting for the need of adequate and consistent provision of personnel and spatial resources.

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“…In contrast to frequent intoxications with benzodiazepines or alcohol [1], ingestion of alkaline or acid in adults is rare [2]. Diluted acid/alkali usually induces limited mucosal damage.…”

Section: Introductionmentioning

confidence: 99%

Fatal Course of a Suicidal Intoxication with Hydrochloric Acid

Koschny¹,

Herceg

Stremmel³

et al. 2013

Case Rep Gastroenterol

Self Cite

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Suicidal ingestion of undiluted hydrochloric acid is a rare but live-threatening event. We report on the dramatic and fulminant course of a 61-year-old woman who drank 200 ml of 30-33% hydrochloric acid. On admission to our intensive care unit she was alert and oriented with stable vital signs. Gastroscopy demonstrated complete necrosis from the hypopharynx to the pylorus, which was flushed continuously via drainage catheters. At that time point perforation was not evident. Shortly thereafter she developed an acute abdomen and a tension pneumothorax which was decompressed. CT scan demonstrated esophageal and intestinal perforation with massive mediastinal necrosis. On emergency laparostomy she showed complete necrosis of the intestine and stomach. The patient died 10 h after admission from multiorgan failure. The therapeutic options are critically discussed in comparison to previously reported cases in the literature.

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Admission to intensive care for parasuicide by self-poisoning: Variation by time cycles, climate and the lunar cycle

Cited by 14 publications

References 55 publications

Suicide Deaths and Nonfatal Hospital Admissions for Deliberate Self-Harm in the United States

Suicide Deaths and Nonfatal Hospital Admissions for Deliberate Self-Harm in the United States

Limited predictive value of admission time in clinical psychiatry

Fatal Course of a Suicidal Intoxication with Hydrochloric Acid

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