Characteristics of Drug Overdose in Young Suicide Attempters

Abstract

ObjectiveFew studies have focused on the characteristic features of drug overdose in children and adolescents who have attempted suicide in Korea. The present study examined the characteristics of drug overdose in children and adolescents who visited the emergency room following drug ingestion for a suicide attempt.MethodsThe medical records of 28 patients who were treated in the emergency room following a drug overdose from January 2008 to March 2011 were analyzed. Demographic and clinical variables related to the suicide attempts were examined.ResultsThe mean age of the patients was 16.6±1.7 years (range 11-19 years), and 20 of the patients (71.4%) were female. Most of the patients (n=23, 82.1%) overdosed on a single drug; acetaminophen-containing analgesics were the most common (n=12, 42.9%). Depression was the most common psychiatric disorder (n=22, 78.6%), and interpersonal conflict was the most common precipitating factor of the suicide attempts (n=11, 39.3%). This was the first suicide attempt for approximately 80% of the patients. About one fourth of the patients (n=7, 25%) had follow-up visits at the psychiatric outpatient clinic.ConclusionEarly screening and psychiatric intervention for depression may be an important factor in preventing childhood and adolescent suicide attempts. Developing coping strategies to manage interpersonal conflicts may also be helpful. Moreover, policies restricting the amount and kind of drugs purchased by teenagers may be necessary to prevent drug overdose in this age group.

Adolescent deliberate self‐poisoning in South‐East Melbourne

“…We also observed an increasing incidence of DSP with increasing age. Peak incidence was in the 15–17 year and 364 day age group, which is also consistent with other studies of adolescent DSP . Although the reasons for this are not clear, suggestions include the onset of puberty and its association with the development of depression and substance misuse …”

“…This is consistent with previous studies of adolescent self‐poisoning. However, it differs from studies of adult overdose where benzodiazepines, as a group, are the most common substances ingested . This difference suggests that adolescents might have less access to prescription medications.…”

“…The most common risk factor for attempting DSP in adults and adolescents is the female sex . Adolescent DSP is most common between the ages of 15 and 17, with an increasing incidence with every year of age above 12 . The substances used by adolescents for DSP are primarily determined by accessibility, with paracetamol being the most common toxicant internationally .…”

Risk Factors for Serious Suicide Attempts with High Medical Severity

“…Most importantly, school/work problems are shown to produce the greatest odds of medically serious suicide attempts (OR 3.2). School‐related stressors are risk factors for suicide attempts among young adults in many countries (Ang & Huan, ; Hawton, Haigh, Simkin, & Fagg, ; Juon, Nam, & Ensminger, ; Kweon et al, ; Lee, Kim, Choi, & Lee, ). The academic stress–suicide link may be even stronger in Korea, given the familial and cultural demands for academic excellence.…”

“…The BESRA consists of domains concerning demographic factors, clinical diagnosis, patients’ psychiatric resources, and detailed information about the present suicide attempt including method, whether the attempt was planned or impulsive, the reason for the attempt, and risk/rescue rating scores. The BESRA was developed to help clinicians make rapid and accurate decisions in the emergency room (Kim et al, ; Kim, Ko, & Lee, ; Kweon et al, ). Thus, the tool includes assessments of established suicidal risk factors and available resources and risk/rescue scales with confirmed reliability and validity (Misson et al, ).…”