Effects of a drug overdose in a television drama on presentations to hospital for self poisoning: time series and questionnaire study

Abstract

Objectives To determine whether a serious paracetamol overdose in the medical television drama Casualty altered the incidence and nature of general hospital presentations for deliberate self poisoning. Design Interrupted time series analysis of presentations for self poisoning at accident and emergency departments during three week periods before and after the broadcast. Questionnaire responses collected from self poisoning patients during the same periods. Setting 49 accident and emergency departments and psychiatric services in United Kingdom collected incidence data; 25 services collected questionnaire data. Subjects 4403 self poisoning patients; questionnaires completed for 1047. Main outcome measures Change in presentation rates for self poisoning in the three weeks after the broadcast compared with the three weeks before, use of paracetamol and other drugs for self poisoning, and the nature of overdoses in viewers of the broadcast compared with non-viewers. Results Presentations for self poisoning increased by 17% (95% confidence interval 7% to 28%) in the week after the broadcast and by 9% (0 to 19%) in the second week. Increases in paracetamol overdoses were more marked than increases in non-paracetamol overdoses. Thirty two patients who presented in the week after the broadcast and were interviewed had seen the episode-20% said that it had influenced their decision to take an overdose, and 17% said it had influenced their choice of drug. The use of paracetamol for overdose doubled among viewers of Casualty after the episode (rise of 106%; 28% to 232%). Conclusions Broadcast of popular television dramas depicting self poisoning may have a short term influence in terms of increases in hospital presentation for overdose and changes in the choice of drug taken. This raises serious questions about the advisability of the media portraying suicidal behaviour.

Suicide in Adolescents: A Worldwide Preventable Tragedy

“…3 2 Media portrayal of deliberate self-harm has been associated with an increased risk of hospital attendance following deliberate self-poisoning. 83 Careful follow-up of any suicidal youth is important and research suggests that the majority of such youth may not receive adequate follow-up management that then increases the risk of eventual suicide. 1,50,[84][85][86][87][88] …”

Psychiatry and the media

“…When a popular UK programme (BBC's Casualty, with 15.5 million viewers) featured a rapidly fatal paracetamol overdose, this had no impact on regional parasuicide trends (Simkin et al, 1995). However, using similar methods, a later study found that national rates of paracetamol poisoning doubled when the same programme showed the serious consequences of paracetomol overdose in an RAF pilot (Hawton et al, 1999). There are further methodological problems in researching the effects of violence.…”

A multicentre programme of clinical and public health research in support of the National Suicide Prevention Strategy for England

“…There may be potential for educational initiatives highlighting this aspect of paracetamol toxicity, although it is possible that this may have a reverse effect (e.g. an episode of a popular television drama featuring a fatal paracetamol overdose was followed by an increase in similar overdoses among viewers 89 ).…”