Profile of deliberate self-harm patients presenting to Emergency Department: A retrospective study

Jegaraj, Moses Kirubairaj Amos; Mitra, Shubhanker; Kumar, Sathish; Selva, Bagyalakshmi; Pushparaj, Manimaran; Yadav, Bijesh; Prabhakar, Abhilash Kundavaram Paul; Alex, Reginald

doi:10.4103/2249-4863.184627

Cited by 17 publications

(23 citation statements)

References 14 publications

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“…Our findings are congruent with other studies that report self-poisoning as a leading method of self-harm. 29 , 30 , 31 Despite high rates of self-poisoning as the method of self-harm among both groups, a statistically significant greater proportion of the subgroup of CSU patients used damage to body tissue as their method of self-harm. This is a noteworthy finding given that damage to body tissue (e.g.…”

Section: Discussionmentioning

confidence: 96%

“…Integrating a psychiatric assessment within primary care could be an important component of preventing repetition of self-harm by ensuring that adequate treatment strategies are followed; psychiatric assessments also provide an opportunity to refer self-harm patients to available mental health services. 31 , 48 …”

Section: Discussionmentioning

confidence: 99%

“…pesticide poisoning) is the leading method of self-harm in LMICs. 10 , 31 Research has consistently shown associations between substance intoxication and method of self-harm, 2 though research in this area on the association of CSU with method of self-harm is scant.…”

Section: Introductionmentioning

confidence: 99%

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Chronic substance use and self-harm in a primary health care setting

Breet

Bantjes

Lewis

2018

Afr. j. prim. health care fam. med.

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BackgroundChronic substance use (CSU) is associated with health problems, including self-harm, placing a significant burden on health care resources and emergency departments (EDs). This is problematic in low- and middle-income countries like South Africa (SA), where primary care facilitates and emergency departments (EDs) are often poorly resourced.AimTo investigate the epidemiology of CSU and self-harm and to consider the implications for primary health care service delivery and suicide prevention in SA.MethodsData were collected from 238 consecutive self-harm patients treated at the emergency department (ED) of an urban hospital in SA. The data were analysed using bivariate and multivariate analyses.ResultsApproximately 37% of self-harm patients reported CSU. The patients in the CSU subgroup, compared to other self-harm patients, were more likely to be men (odds ratio [OR] = 8.33, 95% confidence interval [CI] = 3.19–20.9, p < 0.001), to have self-harmed by inflicting damage to their body tissue OR = 4.45, 95% CI = 1.77–11.2, p < 0.01) and to have a history of self-harm (OR = 3.71, 95% CI = 1.44–9.54, p = 0.007). A significantly smaller proportion of CSU patients, compared to other self-harm patients, were referred for psychiatric assessment (OR = 8.05, 95% CI = 4.16–15.7, p < 0.001).ConclusionThe findings of this study confirm that CSU is associated with greater service utilisation and repetition of self-harm among patients in primary health care settings. Treating self-harm as the presenting problem within primary care settings does not necessarily ensure that patients receive the care that they need. It might be helpful to include psychiatric assessments and screening for CSU as an integral component of care for self-harm patients who present in primary health care settings.

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Section: Discussionmentioning

confidence: 96%

Section: Discussionmentioning

confidence: 99%

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Chronic substance use and self-harm in a primary health care setting

Breet

Bantjes

Lewis

2018

Afr. j. prim. health care fam. med.

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“…With increasing trends of deliberate self-harm, there is a need of a holistic approach to manage depression and other common mental health problems in primary care for preventing people from taking extreme steps. [910]…”

Section: Discussionmentioning

confidence: 99%

Profile of acute poisoning cases and their outcome in a teaching hospital of north India

Mathew

Jamshed

Aggarwal

et al. 2019

J Family Med Prim Care

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Objectives:Aim of this study was to characterize acute poisoning and snakebite cases and their outcome in the Emergency Department (ED).Methods:This was a prospective study done in the ED of a tertiary healthcare center. Study included 184 patients of acute poisoning and 16 cases of snakebite. Data regarding demographics, type, time, and mode of poisoning, lag time in reaching the hospital, initiation of treatment, first aid, in-hospital treatment, and comorbid illness were obtained. Data regarding requirement of antidote, duration of hospitalization, and outcome were also obtained.Results:Out of 200 cases, 181 (90.5%) were adults and 19 (9.5%) were of pediatric age group. Poisoning was common among males (57%) than females (43%). Majority (40%) were from the age group of 21–30 years. Out of 200, 115 (57.5%) poisonings were suicidal, 68 (34%) were accidental, and 17 (8.5%) were homicidal. Acute poisonings included corrosive 54 (27%), drug overdose 26 (13%), organophosphorus compounds 20 (10%), rodenticides 20 (10%), and symptomatic snakebite 16 (8%). Seventy-two (36%) were admitted with a median hospital stay of 6 days with 5 (2.5%) deaths. Logistic regression analysis revealed poorer outcome for 15–30 years age [OR 12.6 (1.6–97.5), P = 0.015], males [OR 2.5 (1.4–4.4) P = 0.04], patients coming from >30 km [OR 4.3 (1.5–12.1), P = 0.006].Conclusion:Our study demonstrated an increased incidence of corrosive ingestion. With increasing rates of suicidal ingestions, there is a need for holistic approach to manage mental health issues at primary care level.

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“… 2 Various methods of DSP as seen in another study done in South India are ingestion of agrochemicals, plant poisons, rodenticides, and drugs. 4 …”

Section: Introductionmentioning

confidence: 99%

Deliberate Self-poisoning due to Plant Toxins: Verdant Footprints of the Past into the Present

Gunasekaran¹,

Abhilash²,

Rabbi³

et al. 2021

Indian Journal of Critical Care Medicine

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A bstract Background Plant poisoning is one of the common methods of deliberate self-poisoning (DSP). Exposure to plants and its consequence account for a considerable number of deaths in rural India. Materials and methods This retrospective observational study was conducted in the emergency department of a large tertiary care hospital in South India over a period of 2 years and recruited patients who presented with DSP from plant poisoning. Results During the study period, 150 cases of plant poisoning were included. The mean (standard deviation) age of presentation was 31.4 (12.2) years. The most common type of plant poison consumed was oleander (63%) followed by oduvanthalai (50%), Strychnos nux-vomica (3%), datura (3%), and others, which comprised about 5.3% included henna (1.3%), cactus (1.3%), and a case each of castor, Gloriosa superba, Adenanthera pavonina, and Abrus precatorius . Patients in age-group 16–30 years had the highest rate of ingestion. The seasonal pattern was found to peak in the month of April. Gastric lavage was done in 102/150:68%. Consumption of decoction [odds ratio (OR): 5, 95% confidence interval (CI): 2.27–14.00, p value: <0.001] and metabolic acidosis (pH <7.35) (OR: 11.48, 95% CI: 4.17–31.57, p value: <0.001) were more common in oduvanthalai poisoning as compared to oleander. The mortality among plant poisoning was 9.3% (14/150). Conclusion Our study sheds light on the spectrum of local plants consumed for DSP. Oleander and oduvanthalai were most commonly used for DSP. Consuming a decoction of leaves leading to severe metabolic acidosis at presentation is seen associated with oduvanthalai poisoning. How to cite this article Abhilash KPP, Murugan S, Rabbi AS, Pradeeptha S, Pradeep R, Gunasekaran K. Deliberate Self-poisoning due to Plant Toxins: Verdant Footprints of the Past into the Present. Indian J Crit Care Med 2021;25(4):392–397.

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Profile of deliberate self-harm patients presenting to Emergency Department: A retrospective study

Cited by 17 publications

References 14 publications

Chronic substance use and self-harm in a primary health care setting

Chronic substance use and self-harm in a primary health care setting

Profile of acute poisoning cases and their outcome in a teaching hospital of north India

Deliberate Self-poisoning due to Plant Toxins: Verdant Footprints of the Past into the Present

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