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Deliberate self-poisoning

Arnaud Gacouin, Adel Maamar, Pierre Fillatre, Emmanuelle Sylvestre, Margaux Dolan, Yves Le Tulzo, Jean Marc Tadié
BACKGROUND: While the psychiatric disorders are conditions frequently encountered in hospitalized patients, there are little or no data regarding the characteristics and short- and long-term outcomes in patients with preexisting psychiatric disorders in ICU. Such assessment may provide the opportunity to determine the respective impact on mortality in the ICU and after ICU discharge with reasons for admission, including modalities of self-harm, of underlying psychiatric disorders and prior psychoactive medications...
December 2017: Annals of Intensive Care
Simon P E Heppell, Geoffrey K Isbister
BACKGROUND: Codeine containing analgesics are commonly taken in overdose, but the frequency of respiratory depression is unknown. We investigated whether paracetamol-codeine combination overdoses caused respiratory depression more than paracetamol alone. METHODS: We reviewed deliberate self-poisoning admissions with paracetamol (>2 g) and paracetamol-codeine combinations presenting to a tertiary toxicology unit (1987-2013). Demographic information, clinical effects, treatment (naloxone, length of stay[LOS], mechanical ventilation) were extracted from a prospective database...
December 30, 2016: British Journal of Clinical Pharmacology
Kimmin Kalyaniwala, Kpp Abhilash, Peter John Victor
Cartap hydrochloride is a moderately hazardous nereistoxin insecticide that is increasingly used for deliberate self-harm in India. It can cause neuromuscular weakness resulting in respiratory failure. We report a patient with 4% Cartap hydrochloride poisoning who required mechanical ventilation for 36-hours. He recovered without any neurological deficits. We also review literature on Cartap hydrochloride poisoning.
August 2016: Journal of the Association of Physicians of India
Mandira Hiremath, Simon Craig, Andis Graudins
OBJECTIVE: To describe the characteristics of adolescents presenting with deliberate self-poisoning (DSP) to a large Australian healthcare network. METHOD: This is a retrospective chart review of 12-17 year olds presenting to three Monash Health EDs with self-poisoning from January 2012 to December 2014. RESULTS: There were 35 207 adolescent presentations in the study period. A total of 721 cases were for DSP (2%), and 501 (1.4%) presented with recreational or accidental self-poisoning...
October 1, 2016: Emergency Medicine Australasia: EMA
Afshin Safaei Asl, Peyman Dadashzadeh
Paraquat and diquat are classified as bipyridyl compounds not only leads to acute organ damage, but also to a variety of complications. Patients with severe paraquat-induced poisoning may succumb to multiple organ failure involving the circulatory and respiratory systems. Deliberate self-poisoning with paraquat continues to be a major public health concern in many developing countries. At present there is no specific antidote to paraquat poisoning, hence the need to more focus on prevention and in cases of poisoning aggressive decontamination to prevent further absorption...
2016: Journal of Renal Injury Prevention
Ian R H Rockett, Christa L Lilly, Haomiao Jia, Gregory L Larkin, Ted R Miller, Lewis S Nelson, Kurt B Nolte, Sandra L Putnam, Gordon S Smith, Eric D Caine
Importance: Fatal self-injury in the United States associated with deliberate behaviors is seriously underestimated owing to misclassification of poisoning suicides and mischaracterization of most drug poisoning deaths as "accidents" on death certificates. Objective: To compare national trends and patterns of self-injury mortality (SIM) with mortality from 3 proximally ranked top 10 causes of death: diabetes, influenza and pneumonia, and kidney disease. Data, Setting, and Participants: Underlying cause-of-death data from 1999 to 2014 were extracted for this observational study from death certificate data in the US Centers for Disease Control and Prevention Wide-Ranging Online Data for Epidemiologic Research online databases...
October 1, 2016: JAMA Psychiatry
Moses Kirubairaj Amos Jegaraj, Shubhanker Mitra, Sathish Kumar, Bagyalakshmi Selva, Manimaran Pushparaj, Bijesh Yadav, Abhilash Kundavaram Paul Prabhakar, Alex Reginald
BACKGROUND: Deliberate self-harm (DSH) is a major under-recognized epidemic in the low- and middle-income countries. This is a large retrospective study form the Emergency Department (ED) of Tertiary Care Center of South India to describe the clinicodemographic features of DSH cases. MATERIALS AND METHODS: This is a retrospective study conducted at ED of Christian Medical College, Vellore, India from January 01, 2011 to December 31, 2013. All cases of DSH were included in the study...
January 2016: Journal of Family Medicine and Primary Care
James Barton, Anselm Wong, Andis Graudins
INTRODUCTION: Apixaban is a novel oral anticoagulation agent that exerts its effect through direct factor Xa inhibition. We present a case of multi-drug overdose including apixaban with associated apixaban concentrations. CASE: A 53 year-old man presented to our metropolitan hospital following a deliberate self-poisoning with 200 mg apixaban, 35 mg ramipril, 105 mg bisoprolol, 280 mg atorvastatin, 6 mg colchicine, 37.4 mg magnesium, 4 × 500 mg paracetamol/9...
November 2016: Clinical Toxicology
Bergljot Gjelsvik, Fridtjof Heyerdahl, Jane Holmes, Daniel Lunn, Keith Hawton
Lifetime worst-point suicidality is associated with risk of subsequent death by suicide. Yet little is known about how people who deliberately self-poison (DSP) change their appraisal of suicidal intent of a single DSP episode over time. We assessed whether suicidal intent for a single index episode of DSP changed over time and factors associated with such change. We studied 202 patients admitted for DSP (66.3% female, all Caucasian), 18-85 years old (M = 37.8, SD = 14.8), using a longitudinal design (0, 3, and 12 months)...
July 15, 2016: Suicide & Life-threatening Behavior
Bergljot Gjelsvik, Fridtjof Heyerdahl, Jane Holmes, Daniel Lunn, Keith Hawton
The relationship between suicidal intent and lethality of deliberate self-poisoning (DSP) episodes and their associations with suicide have yielded contradictory findings. The aims of this study were to investigate the association between patients' suicidal intent and independently rated lethality of DSP episodes, and whether the association changes over time. Eighty-nine DSP patients were investigated longitudinally. Self-reported suicidal intent, including perceived likelihood of dying, wish to die, and whether or not the DSP was considered a suicide attempt, was measured at the time of the index episode (t1), 3 months (t2), and 12 months (t3) later...
July 15, 2016: Suicide & Life-threatening Behavior
K Joory, A Farroha, N Moiemen
Self-inflicted burns (SIB) consistently account for a small proportion of burn injuries. There is a wide spectrum of SIB, from minor burns through to major life threatening burn injuries in suicidal patients who have committed self-immolation. Non-fatal deliberate self-harm (DSH) is a common reason for presenting to hospital. This occurs in many forms including wounding, burning and poisoning to name a few. Such behaviours are commonly repeated, sometimes with increasing severity. DSH is a major risk factor for subsequent suicide...
September 30, 2015: Annals of Burns and Fire Disasters
Britt Reuter Morthorst, Bodil Soegaard, Merete Nordentoft, Annette Erlangsen
BACKGROUND: The validity and reliability of suicide statistics have been questioned and few nationwide studies of deliberate self-harm have been presented. AIM: To calculate rates of deliberate self-harm in Denmark in order to investigate trends and assess the reliability of hospital records. METHOD: A register study based on all individuals recorded with an episode of deliberate self-harm or probable deliberate self-harm in nationwide registers during 1994-2011...
July 2016: Crisis
Teris Cheung, Paul S F Yip
AIMS: The aim of this study was to examine the weighed prevalence of self-harm and its correlates among Hong Kong nurses. BACKGROUND: Recent epidemiological data suggest that the weighted prevalence of past-year suicidality among Hong Kong nurses was found to be 14·9%. Deliberate self-harm was a significant correlate of suicidality. Nonetheless, there are few population-based studies exploring the prevalence of self-harm and its correlates among medical occupational groups in Asia...
September 2016: Journal of Advanced Nursing
S Beaune, P Juvin, A Beauchet, E Casalino, B Megarbane
OBJECTIVE: Each year, approximately 165,000 poisonings are managed in the emergency departments (ED) in France. We performed a descriptive analysis of self-poisoned patients admitted to a university hospital ED in the Paris metropolitan area (France) aimed at investigating their outcome and the risk factors for transfer to the intensive care unit (ICU). PATIENTS AND METHODS: We retrospectively reviewed patients' records and performed multivariate logistic regression analysis to identify risk factors for ICU admission...
2016: European Review for Medical and Pharmacological Sciences
J Le Vaillant, L Pellerin, J Brouard, D Nimal-Cuvillon
AIM: Biological complications in adolescents' self-poisoning are not currently evaluated. The aim of this study was to describe the toxicological characteristics of suicide attempts, the ingested substances, and their complications to better prevent the risks associated with deliberate self-poisoning. MATERIALS AND METHODS: This was a descriptive, prospective, single-center study. It took place in the pediatric emergency, hospitalization, and intensive care unit of the Caen University Hospital...
May 2016: Archives de Pédiatrie: Organe Officiel de la Sociéte Française de Pédiatrie
Yanko T Iliev, Marin Y Zagorov, Janet G Grudeva-Popova
Dapsone is a drug commonly used in the treatment of leprosy. In Europe it is rarely prescribed, mostly for the treatment of skin diseases such as dermatitis herpetiformis. Poisoning with dapsone is rare and reports of such cases are of interest for toxicological practice. We describe the only acute dapsone poisoning in a caseload series of 21,000 intoxications treated in the Clinical Toxicology Clinic at St George University Hospital in Plovdiv, Bulgaria between 1999 and 2013. We report on a 36-year-old woman who attempted deliberate self-poisoning with an ingestion of approximately 4...
April 2015: Folia Medica
Damien Viglino, Delphine Bourez, Roselyne Collomb-Muret, Carole Schwebel, Karim Tazarourte, Perrine Dumanoir, Carole Paquier, Vincent Danel, Guillaume Debaty, Maxime Maignan
STUDY OBJECTIVE: We study the performance of capnometry in the detection of early complications after deliberate drug poisoning. METHODS: This was a prospective cohort study of self-poisoned adult patients who presented at an emergency department (ED) between April 20, 2012, and May 6, 2014. Patients who ingested at least 1 neurologic or respiratory depressant drug were included. The primary outcome was the predictive value of an end tidal CO2 (etco2) measurement greater than or equal to 50 mm Hg for the detection of early complications defined a priori by hypoxia requiring oxygen greater than or equal to 3 L/min, bradypnea less than or equal to 10 breaths/min, or ICU admission after intubation or antidote administration because of unresponsiveness to pain or respiratory arrest...
July 2016: Annals of Emergency Medicine
Nan Hu, Rebecca A Glauert, Jianghong Li, Catherine L Taylor
OBJECTIVE: The risk of repetition of deliberate self-harm peaks in the first 7 days after a deliberate self-harm episode. However, thus far no studies have examined the risk factors for repeating deliberate self-harm during this short-term period. We aimed to investigate the effects of socio-demographic factors, self-harm method and mental health factors in adolescents (10-19 years old) and young adults (20-29 years old). METHODS: We used data linkage of population-wide administrative records from hospital inpatients and emergency departments to identify all the deliberate self-harm-related episodes that occurred in adolescents and young adults in Western Australia from 2000 to 2011...
February 2016: Australian and New Zealand Journal of Psychiatry
Joanna Bhaskaran, Eric Johnson, James M Bolton, Jason R Randall, Natalie Mota, Cara Katz, Claudio Rigatto, Kurt Skakum, Dan Roberts, Jitender Sareen
OBJECTIVE: To examine population trends in serious intentional overdoses leading to admission to intensive care units (ICUs) in Winnipeg, Manitoba, Canada. METHOD: Participants consisted of 1,011 individuals presenting to any of the 11 ICUs in Winnipeg, Canada, with deliberate self-poisonings from January 2000 to December 2010. Eight categories of substances were created: poisons, over-the-counter medications, prescription medications, tricyclic antidepressants (TCAs), sedatives and antidepressants, anticonvulsants, lithium, and cocaine...
December 2015: Journal of Clinical Psychiatry
Keith Hawton, Katrina G Witt, Tatiana L Taylor Salisbury, Ella Arensman, David Gunnell, Ellen Townsend, Kees van Heeringen, Philip Hazell
BACKGROUND: Self-harm (SH; intentional self-poisoning or self-injury) is common in children and adolescents, often repeated, and strongly associated with suicide. This is an update of a broader Cochrane review on psychosocial and pharmacological treatments for deliberate SH first published in 1998 and previously updated in 1999. We have now divided the review into three separate reviews; this review is focused on psychosocial and pharmacological interventions for SH in children and adolescents...
December 21, 2015: Cochrane Database of Systematic Reviews
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