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Deliberate self-poisoning

Luca D Borruso, Nicholas A Buckley, Katharine A Kirby, Gregory Carter, Jennifer L Pilgrim, Kate M Chitty
The aim of this study was to determine the relationship between alcohol co-ingestion in an index deliberate self-poisoning (DSP) episode with repeated DSP and subsequent suicide. A retrospective cohort study was conducted involving 5,669 consecutive index presentations to a toxicology service following DSP between January 1, 1996, and October 31, 2010. Records were probabilistically matched to National Coronial Information System data to identify subsequent suicide. Index DSPs were categorized on co-ingestion of alcohol, and primary outcomes analyzed were repetition of any DSP, rates of repeated DSP, time to first repeat DSP, and subsequent suicide...
March 2, 2018: Suicide & Life-threatening Behavior
Hale Talaie, Soheila Nasiri, Mehdi Gheisari, Sahar Dadkhahfar, Soma Ahmadi
Background/aim: Acute unintentional and deliberate poisoning by medications and chemicals is a frequent emergency, especially in Iran. This study aimed to evaluate the frequency and character of skin findings occurring in patients with acute intentional and aunintentional poisoning. Materials and methods: This prospective observational study was performed at the Loghman Hakim Hospital Poison Center over a period of 6 months from April 2016 to September 2016. Data including patient demographics, cause of poisoning, and level of consciousness were collected...
February 23, 2018: Turkish Journal of Medical Sciences
Sualeha S Shekhani, Shagufta Perveen, Dur-E-Sameen Hashmi, Khawaja Akbar, Sara Bachani, Murad M Khan
BACKGROUND: Suicide is a major global public health problem with more than 800,000 incidents worldwide annually. Seventy-five percent of the global suicides occur in low and middle-income countries (LMICs). Pakistan is a LMIC where information on suicidal behavior is limited. The aim of the review is to map available literature on determinants, risk factors and other variables of suicidal behavior in Pakistan. METHOD: This study was based on Arksey and O'Malley's methodological framework of scoping review, combining peer reviewed publications with grey literature...
February 12, 2018: BMC Psychiatry
Lesley Ponraj, Ajay Kumar Mishra, Maria Koshy, Ronald Albert Benton Carey
Strychnine poisoning is a rare method of deliberate self-harm in adults. Poisoning with strychnine leaves is a rare form of strychnine poisoning, as the usual plant parts used are nuts, bark, and seeds. Although the common cardiac manifestations of strychnine positioning include tachycardia and hypertension, we report a patient with mild strychnine poisoning with bradycardia.
July 2017: Journal of Family Medicine and Primary Care
Rohit Ninan Benjamin, Thambu David, Ramya Iyadurai, K S Jacob
Background: People who deliberately ingest poisons commonly present to emergency departments of hospitals in India. However, there is a dearth of information on poisoning using nonorganophosphorus pesticides. Methods: This prospective, hospital-based study attempted to examine the nonorganophosphorus poisons used to attempt suicide. Data on sociodemographic characteristics of patients, site and source of poisons, co-ingested substances, premeditation, and reason for poisoning were collected...
January 2018: Indian Journal of Psychological Medicine
Per Sverre Persett, Tine K Grimholt, Oivind Ekeberg, Dag Jacobsen, Hilde Myhren
BACKGROUND: In Norway, there are about 550 suicides recorded each year. The number of suicide attempts is 10-15 times higher. Suicide attempt is a major risk factor for suicide, in particular when violent methods are used. Suicide attempts with violent methods have hardly been studied in Norway. This study describes demographic, psychiatric and somatic health in patients admitted to somatic hospitals in Norway after suicide attempt by violent methods compared with suicide attempters using deliberate self-poisoning (DSP)...
January 24, 2018: BMC Psychiatry
Chanika Alahakoon, Tharaka Lagath Dassanayake, Indika Bandara Gawarammana, Vajira Senaka Weerasinghe
INTRODUCTION: Ingestion of organophosphorus insecticides (OPI) is a common method of deliberate self harm in the developing world. Deaths mainly follow as a result of the respiratory failure associated with both cholinergic crisis and the intermediate syndrome. Even though death can be prevented by early mechanical ventilation of these patients, limited studies are available regarding the prediction of intermediate syndrome and subsequent respiratory failure. OBJECTIVE: To systematically review articles that are published with regard to possible prediction of intermediate syndrome using clinical, biochemical and electrophysiological parameters...
December 5, 2017: Neurotoxicology
Brijesh Patel
BACKGROUND: In February 2012, the Commission on Human Medicines recommended lowering the paracetamol toxicity treatment threshold for all patients. Children between one month and six years of age are physiologically distinct and metabolise paracetamol differently, making them less prone to toxicity. Furthermore, overdose in early childhood is almost exclusively accidental, as opposed to predominately deliberate self harm seen in adults and adolescents. As a result, the use of the new 75 mg/kg ingestion threshold for young children would appear to be of unproven benefit, and is substantially lower than the threshold used in other countries...
December 2017: Emergency Medicine Journal: EMJ
Mónika Ditta Tóth, Szilvia Ádám, Tamás Zonda, Emma Birkás, György Purebl
In recent years, suicide rates in Hungary have been among the highest in the European Union. Attempted suicide rates in the Roma population are 2-3 times higher than in the non-Roma population. Since individuals making multiple attempts have a higher pro-bability of eventual death by suicide, and there are limited data on suicidal behaviour of the Roma population, the aim of this study was to explore the sociodemographic and psychological background factors of multiple suicide attempts in the Hungarian Roma population...
January 1, 2017: Transcultural Psychiatry
Samir Bhagwat, George Bruxner
OBJECTIVE: The aim of this paper is to provide an overview of the delayed neurologic syndrome of carbon monoxide poisoning and its clinical importance in psychiatric settings. METHOD: A brief review of carbon monoxide poisoning is presented with a focus on the delayed neurologic syndrome and a case of deliberate self- poisoning is described. RESULTS: As in the case described, the delayed manifestations of carbon monoxide poisoning can resemble a relapse of psychiatric illness...
August 1, 2017: Australasian Psychiatry: Bulletin of Royal Australian and New Zealand College of Psychiatrists
Rupeng Mong, Gabriel Joseph Arciaga, Hock Heng Tan
BACKGROUND: A significant proportion of patients with toxic exposures presenting to the ED require admission. However, most will improve within 24 hours, and so could potentially be managed in a short-stay observation unit. We describe the management and outcomes of these patients in a 23-hour ED observation unit (EDOU). METHODS: A retrospective chart review of all patients with toxic exposures admitted to the EDOU in Singapore between 1 April 2013 and 31 March 2015 was performed...
November 2017: Emergency Medicine Journal: EMJ
Kate M Chitty, Katharine Kirby, Nicholas J Osborne, Geoffrey K Isbister, Nicholas A Buckley
OBJECTIVE: Investigating diurnal variation in the timing of suicidal behaviours offers opportunity to better understand its various proximal risk factors. Acute use of alcohol is a potent proximal risk factor for suicidal behaviour, though the nature of this risk is poorly understood. The aim of this study was to compare the diurnal variation in time of poison ingestion between deliberate self-poisonings that involve alcohol versus those that do not. METHODS: A retrospective analysis of consecutive presentations to a toxicology service following deliberate self-poisoning, 1996-2016...
July 1, 2017: Australian and New Zealand Journal of Psychiatry
Mehdi Moradinazar, Farid Najafi, Mohammad Reza Baneshi, Ali Akbar Haghdoost
OBJECTIVES: Rates of attempted deliberate self-poisoning (DSP) are subject to undercounting, underreporting, and denial of the suicide attempt. In this study, we estimated the rate of underreported DSP, which is the most common method of attempted suicide in Iran. METHODS: We estimated the rate and number of unaccounted individuals who attempted DSP in western Iran in 2015 using a truncated count model. In this method, the number of people who attempted DSP but were not referred to any health care centers, n0, was calculated through integrating hospital and forensic data...
2017: Epidemiology and Health
Deepak Gyenwali, Abhinav Vaidya, Sundar Tiwari, Prakash Khatiwada, Daya Ram Lamsal, Shrikrishana Giri
BACKGROUND: Globally, there is a growing concern over pesticides use, which has been linked to self-harm and suicide. However, there is paucity of research on the epidemiology of pesticides poisoning in Nepal. This study is aimed at assessing epidemiological features of pesticides poisoning among hospital-admitted cases in selected hospitals of Chitwan District of Nepal. METHODS: A hospital-based quantitative study was carried out in four major hospitals of Chitwan District...
July 3, 2017: BMC Public Health
Gudborg Audur Gudjonsdottir, Anna Maria Thordardottir, Jakob Kristinsson
INTRODUCTION: The purpose of the study was to assess the incidence and type of toxic exposures presenting to the Emergency Department (ED) at Landspitali University Hospital in Iceland over one year and compare the results to another study performed eleven years before. METHODS: The study was prospective and included all visits due to acute poisoning to the ED between January 1, and December 31, 2012. RESULTS: A total of 977 toxic exposures were documented...
June 2017: Læknablađiđ
Hossein Hassanian-Moghaddam, Fatemeh Ghorbani, Afsaneh Rahimi, Tayyebeh Farmahini Farahani, Parvane Sadat Vafaei Sani, Terry J Lewin, Gregory L Carter
Social influences on suicidal behaviors may be important but are less frequently studied than the influences of mental illness, physical illness, and demographic variables. Major international sporting events may have an impact on suicidal behaviors at the national and local level, an effect possibly mediated by gender and age. We examined the association of hospital-treated deliberate self-poisoning episodes (by gender and by age) in Tehran: before, during, and after the 2014 FIFA World Cup held in Brazil, in which the Iranian national team participated and was eliminated after the pool games...
June 13, 2017: Suicide & Life-threatening Behavior
V E Pashkovskiy, A G Sofronov, A E Dobrovolskaya, G A Prokopovich
The aim of this study is to identify psychosocial characteristics of older people who attempted suicide by self-poisoning. A total of 44 older people with suicide attempts by self-poisoning was examined, 12 of whom were male and 32 were female, their average age was 71,9+10,8. The comparison group consisted of 53 young people - 19 males and 34 females, their average age was 26,6+4,4. In both groups dominated deliberate self-poisoning with antiepileptic, sedative, soporific, Antiparkinson and psychotropic drugs (40,9 % vs 47,2 %, p>0,05)...
2017: Advances in Gerontology, Uspekhi Gerontologii
Thilini Madushanka Wijerathna, Indika Bandara Gawarammana, Dhammika Menike Dissanayaka, Chathura Palanagasinghe, Fathima Shihana, Gihani Dassanayaka, Seyed Shahmy, Zoltan Huba Endre, Fahim Mohamed, Nicholas Alan Buckley
AIM: Acute kidney injury (AKI) is common following deliberate self-poisoning with a combination washing powder containing oxalic acid (H2C2O4) and potassium permanganate (KMnO4). Early and rapid increases in serum creatinine (sCr) follow severe poisoning. We investigated the relationship of these increases with direct nephrotoxicity in an ongoing multicenter prospective cohort study in Sri Lanka exploring AKI following poisoning. METHODS: Multiple measures of change in kidney function were evaluated in 48 consenting patients who had serial sCr and serum cystatin C (sCysC) data available...
November 2017: Clinical Toxicology
Shannon M Fernando, Valérie Charbonneau, Hans Rosenberg
Salicylates are common substances for deliberate self-harm. Acute salicylate toxicity is classically associated with an initial respiratory alkalosis, followed by an anion gap metabolic acidosis. The respiratory alkalosis is achieved through hyperventilation, driven by direct stimulation on the respiratory centers in the medulla and considered as a compensatory mechanism to avoid acidemia. However, in later stages of severe salicylate toxicity, patients become increasingly obtunded, with subsequent loss of airway reflexes, and therefore intubation may be necessary...
2017: Case Reports in Critical Care
J Salles, J Pariente, C Dimeglio, P Gandia, B Lemesle, A Giron, N Franchitto, L Schmitt, E Very
STUDY HYPOTHESIS: In cases of deliberate self-poisoning (DSP), patients often ingest benzodiazepines (BZDs), known to alter memory. Experts recommend recovery of the patient's cognitive capacity before psychiatric assessment. Unfortunately, there is no validated tool in common practice to assess whether sufficient cognitive recovery has occurred after DSP with BZDs to ensure patient memory of the assessment. OBJECTIVE: The aim of the study was to identify cognitive functions and markers which predict preserved memory of the mental health care plan proposed at the emergency department after DSP...
October 2017: Journal of Psychopharmacology
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