Carter G L, Whyte I M, Ball K, Carter N T, Dawson A H, Carr V J, Fryer J
Newcastle Mater Misericordiae Hospital, Waratah, NSW.
Med J Aust. 1999 Apr 5;170(7):307-11. doi: 10.5694/j.1326-5377.1999.tb127783.x.
To describe the hospital-treated prevalences for repeat deliberate self-poisoning (RDSP) and the demographic characteristics of the RDSP group, and to compare the RDSP and non-RDSP groups.
Prospective longitudinal cohort study, with a one- to four-year follow-up.
The Hunter Area Toxicology Service (HATS), a regional toxicology treatment centre in New South Wales.
1238 consecutive DSP patients referred to hospital, 1992-1994, with follow-up through 1995.
Deliberate self-poisoning (DSP) admissions within one year (RDSP-1), within six months (RDSP-6m), and within 28 days (RDSP-28d) of any other DSP admission by the same patient; length of stay; demographic characteristics; and drugs ingested.
175 patients (14.1%) repeated DSP during the study; 165 (13.3%) were classified as RDSP-1, giving a patient prevalence of hospitalisation in the range of 14.6 to 20.7 per 100,000 per year. Fifty-six RDSP-28d patients (33.9% of RDSP-1) accounted for 49.8% of the RDSP-1 admissions, and 123 RDSP-6m patients (74.5% of RDSP-1) accounted for 83.5% of RDSP-1 admissions. For RDSP-1, the male:female ratio was 1:1.9, with 35.7% unemployed, 29.1% pensioners and 15.8% married or in de facto relationships. RDSP-1 patients had a shorter length of stay (3 h), which was not clinically important. RDSP was more likely for the 25-34 years age group (odds ratio [OR], 2.24; 95% confidence interval [CI], 1.17-4.29) and the 35-44 years age group (OR, 2.12; 95% CI, 1.02-4.39) than the 10-18 years group, and more likely for women than men (OR, 1.69; 95% CI, 1.17-2.46). Being married/de facto reduced the risk for repetition (OR, 0.55; 95% CI, 0.31-0.96) compared with being single. Medications indicated for psychiatric illness were most commonly used for DSP.
Many patients who repeat DSP do so after a very brief interval and account for a disproportionate number of hospitalisations. Availability of psychiatric medications for DSP patients is a possible area of intervention.
描述重复故意自毒（RDSP）的住院患病率及RDSP组的人口统计学特征，并比较RDSP组和非RDSP组。
前瞻性纵向队列研究，随访1至4年。
新南威尔士州的区域毒理学治疗中心——亨特地区毒理学服务中心（HATS）。
1992年至1994年连续转诊至医院的1238例故意自毒（DSP）患者，随访至1995年。
同一患者在任何其他DSP入院后1年内（RDSP - 1）、6个月内（RDSP - 6m）和28天内（RDSP - 28d）的故意自毒（DSP）入院情况；住院时间；人口统计学特征；以及摄入的药物。
175例患者（14.1%）在研究期间重复发生DSP；165例（13.3%）被归类为RDSP - 1，每年每10万人中住院患病率在14.6至20.7之间。56例RDSP - 28d患者（占RDSP - 1的33.9%）占RDSP - 1入院人数的49.8%，123例RDSP - 6m患者（占RDSP - 1的74.5%）占RDSP - 1入院人数的83.5%。对于RDSP - 1，男女比例为1:1.9，35.7%失业，29.1%领取养老金，15.8%已婚或处于事实婚姻关系。RDSP - 1患者住院时间较短（3小时），但在临床上无重要意义。25至34岁年龄组（优势比[OR]，2.24；95%置信区间[CI]，1.17 - 4.29）和35至44岁年龄组（OR，2.12；95% CI，1.02 - 4.39）重复发生RDSP的可能性高于10至18岁年龄组，女性比男性更易发生（OR，1.69；95% CI，1.17 - 2.46）。与单身相比，已婚/处于事实婚姻关系可降低重复发生的风险（OR，0.55；95% CI，0.31 - 0.96）。用于精神疾病的药物最常用于DSP。
许多重复发生DSP的患者在很短的间隔后就再次自毒，且占住院人数的比例过高。为DSP患者提供精神科药物可能是一个干预领域。
