Suicidal intention, psychosocial factors and referral to further treatment: A one-year cross-sectional study of self-poisoning

Abstract

BackgroundPatients treated for self-poisoning have an increased risk of death, both by natural and unnatural causes. The follow-up of these patients is therefore of great importance. The aim of this study was to explore the differences in psychosocial factors and referrals to follow-up among self-poisoning patients according to their evaluated intention.MethodsA cross-sectional multicenter study of all 908 admissions to hospital because of self-poisoning in Oslo during one year was completed. Fifty-four percent were females, and the median age was 36 years. The patients were grouped according to evaluated intention: suicide attempts (moderate to high suicide intent), appeals (low suicide intent) and substance-use related poisonings. Multinomial regression analyses compared patients based on their evaluated intention; suicide attempts were used as the reference.ResultsOf all self-poisoning incidents, 37% were suicide attempts, 26% were appeals and 38% were related to substance use. Fifty-five percent of the patients reported previous suicide attempts, 58% reported previous or current psychiatric treatment and 32% reported daily substance use. Overall, patients treated for self-poisoning showed a lack of social integration. Only 33% were employed, 34% were married or cohabiting and 53% were living alone. Those in the suicide attempt and appeal groups had more previous suicide attempts and reported more psychiatric treatment than those with poisoning related to substance use. One third of all patients with substance use-related poisoning reported previous suicide attempts, and one third of suicide attempt patients reported daily substance use. Gender distribution was the only statistically significant difference between the appeal patients and suicide attempt patients. Almost one in every five patients was discharged without any plans for follow-up: 36% of patients with substance use-related poisoning and 5% of suicide attempt patients. Thirty-eight percent of all suicide attempt patients were admitted to a psychiatric ward. Only 10% of patients with substance use-related poisoning were referred to substance abuse treatment.ConclusionsAll patients had several risk factors for suicidal behavior. There were only minor differences between suicide attempt patients and appeal patients. If the self-poisoning was evaluated as related to substance use, the patient was often discharged without plans for follow-up.

Causes of acute poisoning in adults: a retrospective study, in a hospital in Istanbul, Turkey

“…Bjornaas et al (2010a) reported that of all self-poisoning incidents, 37% were suicide attempts, 26% were appeals for help and 38% were related to substance abuse. Studies conducted in our country have shown that most of the poisoning cases are associated with suicide attempts and observed in women (Goksu et al 2002;Cetin et al 2004;Guloglu and Kara 2005;Gunduz et al 2004).…”

Analysis of sociodemographic data of the patients presented to a state hospital because of suicide attempt

“…İntihar girişimi ve intihar olayı birbirinden ayrı kavramlar değildir (2 Hastaların iş durumları incelendiğinde, kadın hastaların %73.03'ünün, erkek hastaların %77.18'inin çalışmadığı saptandı. İntihar vakalarının çoğunun çalışmayan erkek ve kadınlar olduğu ve işsizliğin intihar riski ile bağlantılı olduğu bilinmektedir (10)(11)(12). Çalışmada hastaların %64.18'inin kadın, %35.82'sinin erkek olduğu saptandı.…”

Langtidsprognose etter selvpåførte forgiftninger

“…Dette er sammenfallende med funn i andre studier. Bjornaas et al, 2010). Rusmisbruk var en risikofaktor for overdødelighet i 20-årsperioden, men til tross for dette utskrives mange av disse forgiftningene uten tilbud om oppfølging så lenge de ikke blir vurdert som suicidale.…”

“…I denne studien så vi en overdøde-lighet av alle årsaker, ikke bare rusrelaterte dødsfall. I en studie fra Oslo i 2003 ble 36 % av rusrelaterte forgiftninger utskrevet uten oppfølging, ikke engang hos fastlegen (Bjornaas et al, 2010). Dette kan ikke forsvares med tanke på deres dårlige prognose på lang sikt, og tilbudet til denne pasientgruppen bør styrkes.…”

“…Selv handlinger som vurderes som mer appellpregede, med lav eller ingen suicidal intensjon, kan gå forut for mer alvorlige handlinger. Risikoen for død og selvmord på lang sikt hos denne pasientgruppen viser et behov for mer systematisk oppfølging enn i dag, hvor saerlig suicidal intensjon tillegges vekt ved henvisning videre i hjelpeapparatet (Bjornaas et al, 2010). Rusmisbruk var en risikofaktor for overdødelighet i 20-årsperioden, men til tross for dette utskrives mange av disse forgiftningene uten tilbud om oppfølging så lenge de ikke blir vurdert som suicidale.…”