Effects of a drug overdose in a television drama on presentations to hospital for self poisoning: time series and questionnaire study.
OBJECTIVE
To determine whether a serious paracetamol overdose in the medical television drama Casualty altered the incidence and nature of general hospital presentations for deliberate self poisoning.


METHODS
Interrupted time series analysis of presentations for self poisoning at accident and emergency departments during three week periods before and after the broadcast. Questionnaire responses collected from self poisoning patients during the same periods.


METHODS
49 accident and emergency departments and psychiatric services in United Kingdom collected incidence data; 25 services collected questionnaire data.


METHODS
4403 self poisoning patients; questionnaires completed for 1047.


METHODS
Change in presentation rates for self poisoning in the three weeks after the broadcast compared with the three weeks before, use of paracetamol and other drugs for self poisoning, and the nature of overdoses in viewers of the broadcast compared with non-viewers.


RESULTS
Presentations for self poisoning increased by 17% (95% confidence interval 7% to 28%) in the week after the broadcast and by 9% (0 to 19%) in the second week. Increases in paracetamol overdoses were more marked than increases in non-paracetamol overdoses. Thirty two patients who presented in the week after the broadcast and were interviewed had seen the episode-20% said that it had influenced their decision to take an overdose, and 17% said it had influenced their choice of drug. The use of paracetamol for overdose doubled among viewers of Casualty after the episode (rise of 106%; 28% to 232%).


CONCLUSIONS
Broadcast of popular television dramas depicting self poisoning may have a short term influence in terms of increases in hospital presentation for overdose and changes in the choice of drug taken. This raises serious questions about the advisability of the media portraying suicidal behaviour.
Hawton
K
K
University of Oxford, Department of Psychiatry, Warneford Hospital, Oxford OX3 7JX. Keith.Hawton@psychiatry.oxford.ac.uk
Simkin
S
S
Deeks
J J
JJ
O'Connor
S
S
Keen
A
A
Altman
D G
DG
Philo
G
G
Bulstrode
C
C
D000082:Acetaminophen / Q000506:poisoning; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D018712:Analgesics, Non-Narcotic / Q000506:poisoning; D002648:Child; D016001:Confidence Intervals; D004324:Drama; D062787:Drug Overdose / Q000453:epidemiology; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010342:Patient Acceptance of Health Care; D011041:Poisoning / Q000453:epidemiology* / Q000628:therapy; D011795:Surveys and Questionnaires; D015996:Survival Rate; D013690:Television; D006113:United Kingdom / Q000453:epidemiology
D018712:Analgesics, Non-Narcotic; D000082:Acetaminophen