Unit for Suicide Research, Ghent University, Ghent, Belgium.
Flemish Centre of Expertise in Suicide Prevention, Ghent University, Ghent, Belgium.
PLoS One. 2019 May 2;14(5):e0216317. doi: 10.1371/journal.pone.0216317. eCollection 2019.
Intentional drug overdose is the most common method of self-harm. As psychiatric disorders are very common in self-harm patients, the medication used to treat these disorders can become the means for the self-harm act. The present study aimed at investigating an association between the use of prescribed medication (analgesics and antipyretics, anti-epileptics, antipsychotics, antidepressants and psychostimulants) as a method of self-harm and prescription rates of this medication in Flanders. We investigated the possible effect of gender, alcohol use during the self-harm act and a history of self-harm.
Data from the multicenter study of self-harm in Flanders between 2008 and 2013 were used. The significance of differences in percentages was calculated by GEE and the strength by odds ratios (OR).
There was an increase in the odds of using antidepressants (0.8%) and antipsychotics (2%) among females when the rate of prescription increases. Analgesics and antipyretics (39.3/1,000) and antidepressants (124.9/1,000) were the most commonly prescribed drugs among females. Antidepressants (63.9/1,000) and antipsychotics (26.5/1,000) were the most commonly prescribed drugs among males. Antidepressants and analgesics and antipyretics were the most frequently used medications for self-harm. Analgesics and antipyretics during the self-harm act were more common among first-timers, while repeaters more commonly overdosed using antipsychotics and antidepressants.
These findings suggest that the availability of medication via prescriptions plays an important role in the choice of the medication ingested during the self-harm act. Precautions are necessary when prescribing medication, including restrictions on the number of prescriptions and the return of unused medication to pharmacies after cessation of treatment. These issues should be a focus of attention in the education and training of physicians and pharmacists.
故意药物过量是最常见的自残手段。由于精神障碍在自残患者中非常普遍，因此用于治疗这些障碍的药物可能成为自残行为的手段。本研究旨在调查在使用规定药物（镇痛药和退烧药、抗癫痫药、抗精神病药、抗抑郁药和精神兴奋剂）作为自残手段与规定药物在佛兰德的处方率之间是否存在关联。我们调查了性别、自残过程中饮酒以及自残史的可能影响。
使用了 2008 年至 2013 年在佛兰德进行的多中心自残研究的数据。通过广义估计方程（GEE）计算百分比差异的显著性，并通过优势比（OR）计算强度。
当处方率增加时，女性使用抗抑郁药（0.8%）和抗精神病药（2%）的几率增加。镇痛药和退烧药（39.3/1000）和抗抑郁药（124.9/1000）是女性最常开的药物。抗抑郁药（63.9/1000）和抗精神病药（26.5/1000）是男性最常开的药物。抗抑郁药和镇痛药和退烧药是最常被用于自残的药物。自残过程中使用镇痛药和退烧药在初次使用者中更为常见，而重复使用者更常使用抗精神病药和抗抑郁药过量。
这些发现表明，通过处方获得的药物在选择自残过程中摄入的药物方面起着重要作用。在开具药物时需要谨慎，包括限制处方数量以及在停止治疗后将未使用的药物退还给药店。这些问题应该成为医生和药剂师教育和培训的重点关注对象。
