Eddleston Michael, Karunaratne Ayanthi, Weerakoon Manjula, Kumarasinghe Subashini, Rajapakshe Manjula, Sheriff M H Rezvi, Buckley Nick A, Gunnell David
South Asian Clinical Toxicology Research Collaboration, Center for Tropical Medicine, Nuffield Department of Clinical Medicine, University of Oxford, England.
Clin Toxicol (Phila). 2006;44(3):283-6. doi: 10.1080/15563650600584444.
Although intentional self-poisoning is a major public health problem in rural parts of the Asia-Pacific region, relatively little is known of its epidemiology. We aimed to determine why Sri Lankan self-poisoning patients choose particular poisons, and whether acts of self-harm with highly dangerous poisons were associated with more premeditation and effort.
We interviewed 268 self-poisoning patients presenting to two district general hospitals in rural Sri Lanka.
Eighty-five percent of patients cited easy availability as the basis for their choice of poison. There was little premeditation: more than 50% ingested the poison less than 30 minutes after deciding to self-harm. Patients had little knowledge about treatment options or lethality of the poison chosen. We found no difference in reasons for choice of poison between people ingesting different poisons, despite marked differences in toxicity, and between people who died and those who survived.
Poisons were chosen on the basis of availability, often at short notice. There was no evidence that people using highly toxic poisons made a more serious or premeditated attempt. Restrictions on availability of highly toxic poisons in rural communities must be considered in strategies to reduce the number of intentional self-poisoning deaths in the Asia Pacific region.
尽管故意自我中毒是亚太地区农村地区的一个主要公共卫生问题，但其流行病学情况却鲜为人知。我们旨在确定斯里兰卡自我中毒患者选择特定毒物的原因，以及使用高危险性毒物进行自我伤害的行为是否与更多的预谋和努力相关。
我们对前往斯里兰卡农村地区两家区级综合医院就诊的268名自我中毒患者进行了访谈。
85%的患者称选择毒物的依据是容易获取。几乎没有预谋：超过50%的患者在决定自我伤害后不到30分钟就摄入了毒物。患者对所选毒物的治疗方案或致死性了解甚少。尽管不同毒物的毒性存在显著差异，且死亡患者和存活患者之间也有差异，但我们发现摄入不同毒物的人在选择毒物的原因上没有差异。
毒物的选择基于可获取性，通常是在短时间内做出的决定。没有证据表明使用高毒性毒物的人有更严重或更有预谋的企图。在减少亚太地区故意自我中毒死亡人数的策略中，必须考虑对农村社区高毒性毒物可获取性的限制。
