Deliberate self-poisoning and harm: A meticulous quest of methods in vogue

Abstract

Background: Deliberate self-poisoning and harm (DSPH) is an unabating problem with a wide variation in the methods used across the world. Hence, this study was conducted to understand the current spectrum of methods used for DSPH by patients in our geographic locality and catchment area with special emphasis on newer compounds and drugs used. Methods: This retrospective study included patients presenting with DSPH to the emergency department (ED) between January 2017 and December 2018. Results: This study included 1802 patients, with a mean age of 32 ± 12.7 years. Of the patients, 85% were in the young to middle age group (16–45 years). Agrochemicals (n = 604, 33.5%), drugs (n = 498, 27.6%), plant toxins (n = 150, 8.3%) and rodenticides (n = 145, 8%) were the predominantly used compounds. The major emergency resuscitation procedures required in the ED were intubation (n = 321, 18%), vasopressor support (n = 73, 4%) and cardiopulmonary resuscitation (n = 27, 1.4%). A quarter (23.2%) was discharged stable from the ED, whereas a further 56.5% were discharged stable after hospital admission. The in-hospital mortality rate was 3% (n = 47). Multivariate logistic regression analysis showed rodenticides (odds ratio (OR): 22.32; 95% confidence interval (CI): 8.05–61.88; P = 0.005) and plant poisons (OR: 23.92; 95% CI: 8.95–63.94; P = 0.005) to be the independent predictors of mortality. Conclusion: DSPH is prevalent in the highly productive young age group. Agrochemical ingestion and drug overdose are the most common methods used, whereas rodenticide and plant poisoning are associated with significant mortality.

Suicidal attempts and self‐poisoning: 1‐year retrospective cohort study from the quaternary hospital in Thai metropolitan area

“…We believed that age distribution, urbanization, socioeconomic status, access to healthcare, and access to more toxic substances in the city might play significant roles in the differences 19 . The distribution of age, gender, coexisting psychiatric illnesses, and personality disorders were consistent with several previous studies that reported mental illnesses as risk factors for suicide 20–22 …”

“… 19 The distribution of age, gender, coexisting psychiatric illnesses, and personality disorders were consistent with several previous studies that reported mental illnesses as risk factors for suicide. 20 , 21 , 22 …”

“…19 The distribution of age, gender, coexisting psychiatric illnesses, and personality disorders were consistent with several previous studies that reported mental illnesses as risk factors for suicide. [20][21][22] Although our study population was self-poisoned, 13 patients also employed other methods of self-harm, and most patients have nonfatal previous suicidal attempts of various methods. As method switching (between poisoning and other self-harm methods) is common, lacks discernible patterns, 23 and can eventually lead to completed suicide, 24 all patients, regardless of methods used, should be psychiatrically assessed.…”