Repetition of intentional drug overdose: a population-based study.
Clin Toxicol (Phila)
; 54(7): 585-9, 2016 Aug.
Article
en En
| MEDLINE
| ID: mdl-27172384
ABSTRACT
CONTEXT Intentional overdose is a leading method of self-harm and suicide, and repeat attempts strongly predict eventual death by suicide. OBJECTIVES:
To determine the risk of recurrence after a first intentional overdose. Secondary objectives included characterization of the temporal course and potential predictors of repeat overdose, a strong risk factor for death from suicide.DESIGN:
Population-based cohort study.SETTING:
Ontario, Canada, from 1 April 2002 to 31 March 2013.PARTICIPANTS:
All Ontario residents presenting to an emergency department after a first intentional overdose. MAIN OUTCOMEMEASURES:
The incidence and timing of recurrent overdose.RESULTS:
We followed 81,675 patients discharged from hospital after a first intentional overdose. Overall, 13,903 (17.0%) returned with a repeat overdose after a median interval of 288 (inter-quartile range 62 to 834) days. Of these, 4493 (5.5%) had multiple repeat episodes. Factors associated with repeat self-poisoning included psychiatric care in the preceding year (adjusted hazard ratio [aHR] 1.55; 95% confidence interval [CI] 1.50 to 1.61), alcohol dependence (aHR 1.41; 95% CI 1.35 to 1.46) and documented depression (aHR 1.39; 95% CI 1.34 to 1.44). Female sex, rural residence, lower socioeconomic status, ingestion of psychoactive drugs and younger age were also weakly associated with repeat overdose.DISCUSSION:
Hospital presentation for repetition of intentional overdose is common, with recurrent episodes often far removed from the first. While several factors predict overdose repetition, none is particularly strong.CONCLUSION:
Secondary prevention initiatives should be implemented for all individuals who present to the emergency department and survive intentional overdose.Palabras clave
Texto completo:
1
Colección:
01-internacional
Base de datos:
MEDLINE
Contexto en salud:
1_ASSA2030
/
2_ODS3
/
8_ODS3_consumo_sustancias_psicoactivas
Problema de salud:
1_medicamentos_vacinas_tecnologias
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2_sustancias_psicoativas
/
8_alcohol
Asunto principal:
Conducta Autodestructiva
/
Sobredosis de Droga
Tipo de estudio:
Etiology_studies
/
Incidence_studies
/
Observational_studies
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Prognostic_studies
/
Risk_factors_studies
Límite:
Adult
/
Aged
/
Female
/
Humans
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Male
/
Middle aged
País/Región como asunto:
America do norte
Idioma:
En
Revista:
Clin Toxicol (Phila)
Asunto de la revista:
TOXICOLOGIA
Año:
2016
Tipo del documento:
Article