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Deliberate self-poisoning presenting at a rural hospital in Northern Ireland 1976–1996: relationship to prescribing

Published online by Cambridge University Press:  16 April 2020

C.B. Kelly ,
J. Weir ,
T. Rafferty  and
R. Galloway
C.B. Kelly*
Affiliation:
Department of Mental Health, The Queen’s University of Belfast, Whitla Building, 97 Lisburn Rd, BelfastBT97BL, N Ireland
J. Weir
Affiliation:
Craigavon Area Hospital, Craigavon, County Armagh, N Ireland
T. Rafferty
Affiliation:
Drug Utilisation Research Unit, The Queen’s University of Belfast, Belfast, N Ireland
R. Galloway
Affiliation:
Craigavon Area Hospital, Craigavon, County Armagh, N Ireland
*
*Correspondence and reprints
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Summary

Purpose – This study reports on a project to monitor deliberate self-poisoning in a rural area of Northern Ireland over a 20-year period. Comparison is made with reports from large urban centres. In addition, a local prescribing database allows assessment of any association between psychotropic drug prescription and use for deliberate self-poisoning. Materials and methods – Frequency of self-poisoning, demographic details and drugs used were recorded for all episodes of deliberate self-poisoning occurring at Craigavon Area Hospital for the years 1976, 1986, 1991 and 1996. It was possible to compare prescriptions of psychotropic drugs with their use for deliberate self-poisoning between the years 1991 and 1996 in the region served by the hospital, using the Defined Daily Dose (DDD) system. Results – In this rural area the pattern of deliberate self-poisoning has changed, as in urban centres, with a rise in frequency and the male/female ratio approaching unity. The pattern of drug use has altered, with paracetamol overtaking benzodiazepines as the most commonly used agent. More recently, antidepressants have become the second most frequently used drug class for this purpose. Psychotropic medications used for self-poisoning altered in proportion to their prescription between the years 1991 and 1996. Conclusions – In the face of a continuing rise in deliberate self-poisoning, which is effecting both urban and rural areas, care should be taken to prescribe the least toxic agent available as this is associated with likely frequency of self-poisoning for most classes of psychotropic drug.

Keywords

antidepressantsattempted suicideoverdoseparacetamol
Type
Original article
Information
European Psychiatry , Volume 15 , Issue 6 , September 2000 , pp. 348 - 353
Copyright
Copyright ©Éditions scientifiques et médicales Elsevier SAS 2000

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References

Alsen, M, Ekedahl, A, Lowenhielm, P, Nimeus, A, Regnell, G, Traskman-Bendz, LMedicine self-poisoning and the sources of the drugs in Lund, Sweden Acta Psychiatr Scand 89 1994 255–261CrossRefGoogle ScholarPubMed
Bialas, M.C, Reid, P.G, Beck, P et al. Changing patterns of self-poisoning in a UK health district Q J M 89 1996 893–901CrossRefGoogle Scholar
Bille-Brahe, U, Kerkhof, A, De Leo, D et al. A repetition-prediction study of European parasuicide populations: a summary of the first report from Part II of the WHO/EURO multi-centre study on parasuicide in co-operation with the EC Concerted Action on attempted suicide Acta Psychiatr Scand 95 1997 81–86CrossRefGoogle Scholar
Brewer, C, Farmer, RSelf-poisoning in 1984: a prediction that didn’t come true Br Med J 290 1985 391391CrossRefGoogle Scholar
British Medical Association. British National Formulary London: British Medical Association 1998Google Scholar
Darragh, PEpidemiology of suicide in Northern Ireland 1984-1989 Irish J Med Sci 160 1991 354–357CrossRefGoogle ScholarPubMed
Department of Health. Hospital Episode Statistic System 1993-1994. Finished consultant episodes by diagnosis, operation and speciality – poisoning and toxic effects London:Department of Health 1994Google Scholar
D’Mello, D.A, Finkbeiner, D.S, Kocher, K.NThe cost of antidepressant overdose Gen Hosp Psychiatry 17 1995 454–455CrossRefGoogle ScholarPubMed
Fuller, G.N, Rea, A.J, Payne, F.J, Lant, A.FParasuicide in central London 1984-1988 J Roy Soc M 82 1989 653–656CrossRefGoogle ScholarPubMed
Gunnell, D, Hawton, K, Murray, V et al. Use of paracetamol for suicide and non-fatal poisoning in the UK and France: are restrictions on availability justified J Epidemiol Community Health 51 1997 175–179CrossRefGoogle ScholarPubMed
Hawton, K, Fagg, JSuicide and other causes of death following attempted suicide Br J Psychiatry 152 1988 359–366CrossRefGoogle ScholarPubMed
Hawton, K, Ware, C, Mistry, H et al. Paracetamol self-poisoning characteristics, prevention and harm reduction Br J Psychiatry 168 1996 43–48CrossRefGoogle ScholarPubMed
Hawton, K, Fagg, J, Simkin, S, Bale, E, Bond, ATrends in deliberate self-harm in Oxford, 1985-1995 Br J Psychiatry 171 1997 556–560CrossRefGoogle Scholar
Henry, JEpidemiology and relative toxicity of antidepressant drugs in overdose Drug Safety 16 1997 374–390CrossRefGoogle ScholarPubMed
House, A, Owens, D, Storer, DPsychosocial intervention following attempted suicide: is there a case for better services Int Review Psychiatry 4 1992 15–22CrossRefGoogle Scholar
Kelly, C, Galloway, RDeliberate self-poisoning presenting at Craigavon Area Hospital:1976 and 1986 Ulster Med J 61 1992 12–18Google ScholarPubMed
Lane, RSSR1-induced extrapyramidal side-effects and akathisia: implications for treatment J Psychopharmacol 12 1998 192–215CrossRefGoogle ScholarPubMed
Melander, A, Henricson, K, Stenberg, P et al. Anxiolytic-hypnotic drugs: relations between prescribing, abuse and suicide Eur J Clin Pharmacol 41 1991 525–529CrossRefGoogle Scholar
Morgan, H.G, Burns-Cox, C, Pocock, H, Pattle, SDeliberate self-harm: clinical and socio-economic characteristics of 368 patients Br J Psychiatry 127 1975 564–574CrossRefGoogle ScholarPubMed
Oydvin, K, Kristinnson, AGuidelines for DDDWorld Health Organisation Collaborating Centre for Drug Statistics Methodology 1991 WHO: OsloGoogle Scholar
Paykel, E, Priest, RRecognition and management of depression in general practice: consensus statement Br Med J 305 1992 1198–1202CrossRefGoogle ScholarPubMed
Quigley, N, Galloway, R, Kelly, CChanges in the pattern of deliberate self poisoning presenting at Craigavon Area Hospital: 1976, 1986 and 1991 Ulster Med J 63 1994 155–161Google ScholarPubMed
Retterstol, NDeath due to overdose of antidepressants: experiences from Norway Acta Psychiatr Scand Suppl 371 1993 28–32CrossRefGoogle ScholarPubMed
Royal College of Psychiatrists The general hospital management of adult deliberate self harm 1994 The Royal College of Psychiatrists LondonGoogle Scholar
Van der Sande, R, Buskens, E, Allant, E, Van der Graaf, Y, Van Engeland, HPsychosocial intervention following suicide attempt: a systematic review of treatment interventions Acta Psychiatr Scand 96 1997 43–50CrossRefGoogle ScholarPubMed
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