Departments of Psychology, University of Manitoba, Winnipeg, Manitoba, Canada.
J Clin Psychiatry. 2015 Dec;76(12):e1583-9. doi: 10.4088/JCP.14m09568.
To examine population trends in serious intentional overdoses leading to admission to intensive care units (ICUs) in Winnipeg, Manitoba, Canada.
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. Using the population of Winnipeg as the denominator, we conducted generalized linear model regression analyses using the Poisson distribution with log link to determine significance of linear trends in overdoses by substance over time.
Women accounted for more presentations than men (57.8%), and the largest percentage of overdoses occurred among individuals in the 35- to 54-year age range. A large proportion of admissions were due to multiple overdoses, which accounted for 65.7% of ICU admissions. At the population level, multiple overdoses increased slightly over time (incidence rate ratio [IRR] = 1.02, P < .05), whereas use of poisons (IRR = 0.897, P < .01), over-the-counter medications (IRR = 0.910, P < .01), nonpsychotropic prescription medications (IRR = 0.913, P < .01), anticonvulsants (IRR = 0.880, P < .01), and TCAs (IRR = 0.920, P < .01) decreased over time. Overdoses did not change over time as a function of age or sex. However, severity of overdoses classified by length of stay increased over time (IRR = 1.08, P < .01).
It is important for physicians to exercise vigilance while prescribing medication, including being aware of other medications their patients have access to.
研究导致加拿大马尼托巴省温尼伯市重症监护病房（ICU）收治的严重故意过量用药的人群趋势。
参与者包括 2000 年 1 月至 2010 年 12 月期间，因蓄意自我中毒而在加拿大温尼伯的 11 家 ICU 就诊的 1011 人。创建了 8 类物质：毒药、非处方药物、处方药物、三环抗抑郁药（TCAs）、镇静剂和抗抑郁药、抗惊厥药、锂和可卡因。我们使用温尼伯市的人口作为分母，使用泊松分布和对数链接进行广义线性模型回归分析，以确定随时间推移各种物质过量的线性趋势的显著性。
女性比男性多（57.8%），而 35 至 54 岁年龄组的过量用药比例最大。大量的住院是由于多次过量用药，占 ICU 住院人数的 65.7%。在人口水平上，多次过量用药略有增加（发病率比[IRR] = 1.02，P <.05），而毒药（IRR = 0.897，P <.01）、非处方药物（IRR = 0.910，P <.01）、非精神类处方药物（IRR = 0.913，P <.01）、抗惊厥药（IRR = 0.880，P <.01）和 TCAs（IRR = 0.920，P <.01）的使用随着时间的推移而减少。随着时间的推移，过量用药的年龄和性别比例没有变化。然而，根据住院时间长短分类的过量用药的严重程度随着时间的推移而增加（IRR = 1.08，P <.01）。
医生在开具药物时保持警惕很重要，包括了解患者可以获得的其他药物。
