Doherty Zakary, Wong Anselm, Hayman Jane, Greene Shaun
School of Rural Health, Monash University, Bendigo, VIC, Australia.
Alfred Health, Melbourne, VIC, Australia.
Aust N Z J Psychiatry. 2023 Mar;57(3):432-441. doi: 10.1177/00048674221098636. Epub 2022 May 14.
To describe the rates and trends of emergency department presentations and calls to a state poisons centre for antidepressant overdose.
A retrospective cohort study utilising the Victorian Emergency Minimum Dataset and Victorian Poisons Information Centre call registry between January 2009 and December 2018 was conducted. This captured all presentations to Victorian emergency departments and calls to the Victorian Poisons Information Centre. Any intentional overdose involving an antidepressant was included. Annual rates of emergency department presentations and calls per 100,000 persons and 100,000 prescriptions for antidepressants overall and individual antidepressant classes, in addition to age-group-specific rates, were reported.
A total of 3650 presentations to emergency department and 7096 calls to the poisons centre were included. No changes were seen in overall emergency department presentation rates when controlled for population or prescription numbers, but large and significant increases were seen for younger age groups. The 10-14- and 15-19-year age groups had average annual increases of 13.1% (95% CI = [6.5%, 19.7%], < 0.001) and 7.2% (95% CI = [2.8%, 11.5%], < 0.001) per 100,000 persons, respectively. Increases were seen in overall annual call rates of 6.7% (95% CI = [5.2%, 8.1%], < 0.001) per 100,000 persons and 7.5% (95% CI = [4.9%, 10.1%], < 0.001) per 100,000 prescriptions.
Overall, emergency department presentation rates remained stable during the study period. Overall poisons centre call rates increased moderately. However, when examining younger persons, large increases were seen in both emergency department presentations and poison centre call rates. These findings highlight the need for future interventions to mitigate against intentional overdose in younger populations.
描述因过量服用抗抑郁药前往急诊科就诊及致电州毒物中心的发生率和趋势。
进行一项回顾性队列研究，利用2009年1月至2018年12月期间的维多利亚州急诊最低数据集和维多利亚州毒物信息中心呼叫登记册。这涵盖了所有前往维多利亚州急诊科就诊的情况以及致电维多利亚州毒物信息中心的情况。任何涉及抗抑郁药的故意过量服用均包括在内。报告了每10万人以及每10万张抗抑郁药处方的急诊科就诊和呼叫的年发生率，以及总体和各抗抑郁药类别的年发生率，此外还报告了特定年龄组的发生率。
共纳入3650例前往急诊科就诊的病例和7096次致电毒物中心的情况。在对人口或处方数量进行控制后，总体急诊科就诊率未见变化，但较年轻年龄组出现了大幅且显著的增长。10 - 14岁和15 - 19岁年龄组每10万人的年平均增长率分别为13.1%（95%置信区间 = [–6.5%, 19.7%]，< 0.001）和7.2%（95%置信区间 = [2.8%, 11.5%]，< 0.001）。每10万人的总体年呼叫率增长了6.7%（95%置信区间 = [5.2%, 8.1%]，< 0.001），每10万张处方的年呼叫率增长了7.5%（95%置信区间 = [4.9%, 10.1%]，< 0.001）。
总体而言，在研究期间急诊科就诊率保持稳定。毒物中心的总体呼叫率适度增加。然而，在研究较年轻人群时，急诊科就诊率和毒物中心呼叫率均出现了大幅增长。这些发现凸显了未来采取干预措施以减少年轻人群故意过量服用情况的必要性。
