A cross-sectional observation of the factors associated with deliberate self-poisoning with acetaminophen: impact of gender differences and psychiatric intervention.
OBJECTIVE
The objectives of this study were to determine the risk factors and life stressors that are prevalent among the acetaminophen deliberate self-poisoning (DSP) cases, to identify gender differences in the associated factors, and to determine the prevalence of psychiatric diagnosis and the patterns and types of psychotherapeutic interventions provided by psychiatrists.


METHODS
This is a cross-sectional study, a retrospective descriptive case review of hospital admissions for acetaminophen DSP.


RESULTS
There were 177 incidences of DSP during the study period. The mean age of the cases was 23.1 +/- 7.3 years and 84.1% of them were females. The risk factors were more significantly associated with males: chronic ethanol intake (p = 0.04), higher reported dose ingested (p = 0.01), higher latency time (p = 0.04) and longer hospital stay (p = 0.03). The most commonly reported psychotherapeutic interventions used by psychiatrists were psychoeducation of the patient, followed by referral to a psychiatric clinic, family psychoeducation and psychotropic medication. Sertraline (SSRI) was the most frequently prescribed antidepressant.


CONCLUSIONS
Males have been shown to use more toxic doses and to delay treatment due to high latency time. Most DSP patients have different life stressors and psychiatric diagnoses that may be associated with varying degrees of suicidal intent. All patients presenting following DSP need to be carefully screened for psychiatric illness. Randomized controlled studies need to be conducted on DSP patients with psychiatric illness to determine which treatments are effective.
Zyoud
Sa'ed H
SH
WHO Collaborating Centre for Drug Information, National Poison Centre, Universiti Sains Malaysia (USM), Penang, Malaysia. saedzyoud@najah.edu
Awang
Rahmat
R
Sulaiman
Syed Azhar Syed
SA
Al-Jabi
Samah W
SW
D000082:Acetaminophen / Q000506:poisoning*; D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000928:Antidepressive Agents / Q000627:therapeutic use; D003430:Cross-Sectional Studies; D003863:Depression / Q000188:drug therapy; D062787:Drug Overdose; D005260:Female; D006801:Humans; D015994:Incidence; D007902:Length of Stay / Q000706:statistics & numerical data; D008016:Life Change Events; D008296:Malaysia / Q000453:epidemiology; D008297:Male; D001523:Mental Disorders / Q000175:diagnosis / Q000453:epidemiology* / Q000523:psychology; D008875:Middle Aged; D010353:Patient Education as Topic; D015995:Prevalence; D012017:Referral and Consultation; D012189:Retrospective Studies; D012307:Risk Factors; D020280:Sertraline / Q000627:therapeutic use; D012737:Sex Factors; D013406:Suicide, Attempted / Q000517:prevention & control / Q000523:psychology* / Q000706:statistics & numerical data*
D000928:Antidepressive Agents; D000082:Acetaminophen; D020280:Sertraline