The epidemiology of deliberate self poisoning presenting to Christchurch Hospital Emergency Department.

AIM

To review the recent epidemiology of deliberate self poisoning presentations to Christchurch Emergency Department and to compare this with 1992 and 1989 data.

METHOD

A retrospective analysis of case and computer records over the twelve month period of 1996 was conducted and compared with published data for 1992 and 1989.

RESULTS

There were 713 presentations in 1996 to Christchurch Emergency Department with deliberate self poisoning, representing 1.1% (compared with 1.2% 1992; 0.96% 1989) of total presentations. The female to male ratio was 1.9:1.0 (compared with 1.5:1.0, 2.1:1.0). 70.1% of patients presenting were under the age of 35. The principal drugs ingested were antidepressants 20% (compared with 24.4%; 15.7%) paracetamol (16.7% compared with 16.9%; 10.6%) hypnotics/anxiolytics 15.6% (benzodiazepines 11.0% compared with 23.6%; 18.0%), antipsychotics 10.7% (compared with 16.1%; not reported). Gastric decontamination was given to 61% (compared with 73% 1992), charcoal alone used in 54% (compared with 46%; 0.4%), gastric lavage and charcoal 7% (compared with 27%; 78%). 39% received no gastrointestinal decontamination (compared with 27% 1992). Of the patients presenting, 68.9% were admitted (compared with 59%; 66%), 10.2% to Intensive Care Unit (compared with 11%; 18%). There were 6 deaths (compared with 2; 2).

CONCLUSION

Deliberate self poisoning remains a problem mainly of the young with a gender ratio favouring female. Antidepressant medications, paracetamol, benzodiazepines and antipsychotics remain the most common classes of drugs taken alone or in combination. An important trend within the antidepressants is the increasing misuse of selective serotonin reuptake inhibitors. Rates of admission to hospital and the Intensive Care Unit have changed but mortality rates have had no significant change over the three time periods. Gastrointestinal decontamination techniques employed follow a trend towards the use of activated charcoal and away from gastric lavage.