Epidemiologic profile and triggering factors of voluntary poisoning in teenagers

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Abstract

Self-poisoning is an important medical and social problem in adolescents.

We performed an observational cross-sectional retrospective study on a group of 219 adolescents admitted for voluntary intoxications at “St. Mary” Children's Emergency Hospital, Iasi during 1 year period. Epidemiological aspects and triggering factors have been analyzed. Data collected from the patients’ files were centralized in an SPSS 18.0 database and processed with confidence interval of 95%.

We found that pharmaceutical drugs have been usually involved (34.7%), mostly in girls (56.3% vs. 15.5%; P = 0.0001). The most frequently cited reason for poisoning was family conflict, with a relative risk (RR) 1.43 times higher in girls, as well as scholar conflict (RR = 1.39). A great percentage of the monitored girls presented severe depression (23.3% vs. 6.9%; P = 0.001), with an RR more than 3 times higher than in the case of boys. All cases evolved favorably, no death having been recorded, even if 18 teenagers initially presented an extremely serious condition, being admitted in various stages of coma (Glasgow coma scale score < 8).

We found that self-inflicted poisonings with pharmaceutical drugs was more common in girls and the use of drug and alcohol intoxication was found especially in boys. The most common pharmaceutical drug involved in self-poisoning was acetaminophen. Psychological disorders and family or school conflicts are the most important triggering factors of voluntary poisoning. Risk factors should be identified after stabilizing the patient, and actions should be taken in order to prevent a fatal recurrence.

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Deliberate self-harm within an international community sample of young people: comparative findings from the Child & Adolescent Self-harm in Europe (CASE) Study.

Nicola Madge, Anthea Hewitt, Keith Hawton … (2008)

Deliberate self-harm among young people is an important focus of policy and practice internationally. Nonetheless, there is little reliable comparative international information on its extent or characteristics. We have conducted a seven-country comparative community study of deliberate self-harm among young people. Over 30,000 mainly 15- and 16-year-olds completed anonymous questionnaires at school in Australia, Belgium, England, Hungary, Ireland, the Netherlands and Norway. Study criteria were developed to identify episodes of self-harm; the prevalence of self-harm acts and thoughts, methods used, repetition, reasons given, premeditation, setting for the act, associations with alcohol and drugs, hospitalisation, and whether other people knew, were examined. Self-harm was more than twice as common among females as males and, in four of the seven countries, at least one in ten females had harmed herself in the previous year. Additional young people had thought of harming themselves without doing so. More males and females in all countries except Hungary cut themselves than used any other method, most acts took place at home, and alcohol and illegal drugs were not usually involved. The most common reasons given were 'to get relief from a terrible state of mind' followed by 'to die', although there were differences between those cutting themselves and those taking overdoses. About half the young people decided to harm themselves in the hour before doing so, and many did not attend hospital or tell anyone else. Just over half those who had harmed themselves during the previous year reported more than one episode over their lifetime. Deliberate self-harm is a widespread yet often hidden problem in adolescents, especially females, which shows both similarities and differences internationally.

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Adolescent suicide attempts: risks and protectors.

Jamie Ireland, Iris Borowsky, Susan Resnick (2001)

In 1997, suicide was the third leading cause of death among 10- to 19-year-olds in the United States, with the greatest increases in suicide rates in the previous decade experienced by black and other minority youth. The purpose of this study was to identify risk and protective factors for suicide attempts among black, Hispanic, and white male and female adolescents. We used data from the National Longitudinal Study of Adolescent Health, conducted in 1995 and 1996. A nationally representative sample of 13 110 students in grades 7 through 12 completed 2 in-home interviews, an average of 11 months apart. We examined Time 1 factors at the individual, family, and community level that predicted or protected against Time 2 suicide attempts. Perceived parent and family connectedness was protective against suicide attempts for black, Hispanic, and white girls and boys, with odds ratios ranging from 0.06 to 0.32. For girls, emotional well-being was also protective for all of the racial/ethnic groups studied, while a high grade point average was an additional protective factor for all of the boys. Cross-cutting risk factors included previous suicide attempt, violence victimization, violence perpetration, alcohol use, marijuana use, and school problems. Additionally, somatic symptoms, friend suicide attempt or completion, other illicit drug use, and a history of mental health treatment predicted suicide attempts among black, Hispanic, and white females. Weapon-carrying at school and same-sex romantic attraction were predictive for all groups of boys. Calculating the estimated probabilities of attempting suicide for adolescents with increasing numbers of risk and protective factors revealed that the presence of 3 protective factors reduced the risk of a suicide attempt by 70% to 85% for each of the gender and racial/ethnic groups, including those with and without identified risk factors. In these national samples of black, Hispanic, and white youth, unique and cross-cutting factors derived from a resiliency framework predicted or protected against attempting suicide. In addition to risk reduction, promotion of protective factors may offer an effective approach to primary as well as secondary prevention of adolescent suicidal behavior.

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Gender differences in suicide attempts from adolescence to young adulthood.

P Lewinsohn, Corrine J. Seeley, Carole C. Baldwin … (2001)

To examine associations of age, gender, and psychosocial factors during adolescence with risk of suicide attempt between ages 19 and 23 years. Initial assessments were conducted with 1,709 adolescents (aged 14-18) in western Oregon between 1987 and 1989. One year later, 1,507 participants returned for a second assessment. A subset of participants (n = 941; 57.2% women) had a third diagnostic assessment after turning 24 (between 1993 and 1999). Information on suicidal behavior, psychosocial risk factors, and lifetime DSM-III-R psychiatric diagnosis was collected at each assessment. The suicide attempt hazard rate for female adolescents was significantly higher than for male adolescents (Wilcoxon chi 2(1)[n = 941] = 12.69, p < .001). By age 19, the attempt hazard rate for female adolescents dropped to a level comparable with that of male adolescents. Disappearance of the gender difference for suicide attempts by young adulthood was not paralleled by a decrease in the gender difference for major depression. Adolescent suicidal behavior predicted suicide attempt during young adulthood for female, but not male, participants. Adolescent psychosocial risk factors for suicide attempt during young adulthood were identified separately for girls and boys. Unlike depression, the elevated incidence rate of suicide attempts by adolescent girls is not maintained into young adulthood. Screening and prevention implications are discussed.

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Author and article information

Journal

Journal ID (nlm-ta): Medicine (Baltimore)

Journal ID (iso-abbrev): Medicine (Baltimore)

Journal ID (publisher-id): MEDI

Title: Medicine

Publisher: Wolters Kluwer Health

ISSN (Print): 0025-7974

ISSN (Electronic): 1536-5964

Publication date Collection: February 2017

Publication date (Electronic): 03 February 2017

Volume: 96

Issue: 5

Electronic Location Identifier: e5831

Affiliations

[a ]Pediatrics Department, University of Medicine and Pharmacy “Grigore T. Popa”

[b ]“St. Mary” Children Emergency Hospital, Iasi, Romania.

Author notes

[∗ ]Correspondence: Otilia Elena Frasinariu, Pediatrics Department, University of Medicine and Pharmacy “Grigore T. Popa”, 16 Universitatii Street, Iasi 700115, Romania (e-mail: otiliafrasinariu@ 123456gmail.com ).

Article

Publisher ID: MD-D-16-05501 Accession ID: 05831

DOI: 10.1097/MD.0000000000005831

PMC ID: 5293421

PubMed ID: 28151858

SO-VID: dd98a248-fa66-4439-a6dc-9616f0f01e28

License:

This is an open access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND), where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal. http://creativecommons.org/licenses/by-nc-nd/4.0

History

Date received : 31 August 2016

Date revision received : 6 December 2016

Date accepted : 13 December 2016

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Keywords: intoxication,suicide attempts,teenager,voluntary poisoning

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Keywords: intoxication, suicide attempts, teenager, voluntary poisoning

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Epidemiologic profile and triggering factors of voluntary poisoning in teenagers

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Most cited references 17

Deliberate self-harm within an international community sample of young people: comparative findings from the Child & Adolescent Self-harm in Europe (CASE) Study.

Adolescent suicide attempts: risks and protectors.

Gender differences in suicide attempts from adolescence to young adulthood.

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