Distinct psychopathology of patients who attempted suicide with rodenticide in Taiwan: a comparative study with patients of suicide with paraquat

Abstract

ObjectiveRodenticide as a means of suicide has been documented for centuries. However, this method is often discussed in conjunction with other pesticides. Thus, we aimed to focus on patients who committed suicide with rodenticide and compared them with those who used paraquat for suicide, another frequently used yet lethal method, to highlight the different psychopathology of patients who choose rodenticide as their means of suicide.MethodsA 12-year retrospective chart review was conducted on the medical records of all patients admitted to Chang Gung Memorial Hospital due to attempted suicide by either rodenticide or paraquat. Psychiatric consultation sheets were collected to ascertain the psychiatric comorbidity and the major stressor for suicide, measured by the Social Readjustment Rating Scale. A χ2 test and logistic regression were used for group comparisons.ResultsSeventeen rodenticide and 157 paraquat suicide attempts were identified. Compared with suicides by paraquat, suicides by rodenticide had a more even distribution in the gender ratio but a lower Social Readjustment Rating Scale score (p<0.001). Depressive disorder was the most common diagnosis in suicides by rodenticide and paraquat. However, schizophrenia and psychotic disorder (29.4%) was the second most common diagnosis and a significant predictor of suicide by rodenticide (odds ratio =9.21, 95% confidence interval =1.2–66.07, p=0.027).ConclusionHigh comorbidity of psychosis in suicide by rodenticide warrants disease-specific suicide prevention and additional large-scale research to confirm this association.

Incidence of intoxication events and patient outcomes in Taiwan: A nationwide population-based observational study

“…We found that patients with previous psychiatric illnesses were more likely present to an ED with intoxication, have more severe intoxication, and die from intoxication. These results are consistent with previous studies that patients with psychiatric illness had higher drug overdose [ 40 – 43 ]. Additionally, in our study, these patients had longer hospital LOS, but lower daily medical expenses.…”

Incidence of Intoxication Events and Patient Outcomes in Taiwan: a Nationwide Population-based Observational Study

“…We found that patients with previous psychiatric illnesses were more likely present to an ED with intoxication, have more severe intoxication, and die from intoxication. These results are consistent with previous studies that patients with psychiatric illness had higher risks of drug overdose (30)(31)(32)(33). However, in our study these patients had longer hospital LOS, but lower daily medical expenses.…”

Adjustment Disorder and Suicidal Behaviours Presenting in the General Medical Setting: A Systematic Review

“…Eighteen of the twenty studies (90%) showed a higher proportion of females than males in suicidal populations, with five studies having women representing more than 80% of the sample: 86% female in Magat et al’s study, 83% in Zhargami et al, 81.5% in Suss et al, 80.4% in Farzeneh et al and 80% in Abumadani et al [12,13,14,20,21]. The two studies with a majority of male participants were both from Taiwan: with 60% male participants in Lin’s 2012 study of charcoal poisoning, and 75% male in Lin’s 2018 study of rodenticide and paraquat poisoning (78% in the paraquat subgroup were male) [26,27].…”

“…A number of the studies reviewed found AD to be a common diagnosis among those presenting for emergency assessment following self-harm. The lowest proportion of AD found was reported by Lin et al (9.8%) in patients presenting with self-poisoning with either rodenticide or paraquat in Taiwan [27]. Ghimire et al reported that 13.5% of the patients presenting to a Nepalese ED with self-poisoning had a clinical diagnosis of AD [17].…”

“…As a result, this study cannot comment on mortality rates in this population. Zarghami et al reported that 79% of the cohort had died as a result of self-immolation [20], and Lin et al reported in their study of poisoning by rodenticide and paraquat that 50% of the cohort (all in the paraquat group) died [27].…”