Masuda Masato, Waters Brian, Gotoh Leo, Nakamura Yoshihiko, Kato Yoshifumi, Nabeshima Shigeki, Kubo Shin-Ichi, Eto Nobuaki, Kawasaki Hiroaki
Department of Psychiatry, Faculty of Medicine, Fukuoka University, Fukuoka, Japan.
Department of Forensic Medicine, Faculty of Medicine, Fukuoka University, Fukuoka, Japan.
Neuropsychopharmacol Rep. 2024 Dec;44(4):809-820. doi: 10.1002/npr2.12492. Epub 2024 Oct 28.
While drugs are sometimes taken during deliberate self-harm (DSH), no study has attempted to analyze drugs in the blood of DSH patients and compare them with prescribed medications or other drugs. In this study, drugs were analyzed from the blood of DSH patients, and the detected, prescribed, and suspected drugs were documented.
Patients who practiced DSH and were transferred to the emergency sites of Fukuoka University Hospital between April 2021 and September 2022 participated in the study. Psychiatrists assessed information such as the history of psychiatric treatment and recent methods of DSH, as well as prescribed drugs within 1 month of presenting to the hospital. Blood samples were analyzed using LC-MS/MS. Participants were divided into groups according to whether or not they were prescribed psychotropics within 1 month.
Fifty-five patients were enrolled in the study. Forty had been prescribed psychotropics within 1 month of hospital admission. However, non-prescribed drugs (NPD) were detected in 42 of the 55 participants (76%). The detection of NPD was significantly high among patients with overdose of medications and OTC drugs (p = 0.036), but NPD were also detected in patients who engaged in other methods (n = 14), and in patients without prescribed medication (n = 10).
This is the first study focused on the drug analysis of blood from patients engaging in DSH. Approximately 80% of the DSH patients in this study had taken NPD, revealing a large discrepancy between prescribed medications and those detected in the blood.
虽然有时会在蓄意自伤（DSH）期间服用药物，但尚无研究试图分析DSH患者血液中的药物，并将其与处方药或其他药物进行比较。在本研究中，对DSH患者血液中的药物进行了分析，并记录了检测到的、处方的和疑似的药物。
2021年4月至2022年9月期间，在福冈大学医院急诊室就诊的DSH患者参与了本研究。精神科医生评估了诸如精神治疗史、近期DSH方法以及入院前1个月内的处方药等信息。使用液相色谱-串联质谱法（LC-MS/MS）分析血样。参与者根据入院前1个月内是否服用精神药物分为两组。
55名患者纳入研究。40名患者在入院前1个月内服用过精神药物。然而，55名参与者中有42名（76%）检测到非处方药（NPD）。在药物和非处方药过量的患者中，NPD的检出率显著较高（p = 0.036），但在采用其他方法的患者（n = 14）和未服用处方药的患者（n = 10）中也检测到了NPD。
这是第一项专注于DSH患者血液药物分析的研究。本研究中约80%的DSH患者服用了NPD，这表明处方药与血液中检测到的药物之间存在很大差异。
