Mechanical ventilation as an indicator of somatic severity of self-poisoning: implications for psychiatric care and long-term outcomes.
BACKGROUND
Somatic severity of a self-poisoning episode varies widely between patients.


OBJECTIVE
To determine the correlates (psychiatric profiles, long-term outcome) of mechanical ventilation used as a proxy to define somatic severity during a self-poisoning.


METHODS
All patients who required mechanical ventilation were pair-matched with ones who did not for age, gender and presence of psychiatric history. One year after the self-poisoning episode, patients were interviewed using the Hospital Anxiety and Depression Scale (HADS) and a quality-of-life assessment questionnaire (Short-Form 12 Health Survey).


RESULTS
The ventilation group (n = 99) more frequently had mood disorders and less frequently had adjustment disorders (P = 0.007), with a higher depression score on the HADS (P = 0.01) than those in the non-ventilation group (n = 97). Survival curves showed lower survival in the ventilation group (P = 0.03).


CONCLUSIONS
Requirement for mechanical ventilation following self-poisoning is associated with a high prevalence of mood disorders and poor long-term outcome.
Elodie Baer, MD, Department of Medical Intensive Care and Hyperbaric Medicine, Angers University Hospital, Angers; Carole Barré, MD, Department of Psychiatry, Angers University Hospital, Angers; Carole Fleury, MD, Department of Medical Intensive Care and Hyperbaric Medicine, Angers University Hospital, Angers; Claire de Montchenu, MD, Department of Psychiatry, Angers University Hospital, Angers; Jean-Bernard Garré, MD, Department of Psychiatry, Angers University Hospital, Angers; Nicolas Lerolle, MD, PhD, Department of Medical Intensive Care and Hyperbaric Medicine, Angers University Hospital, Angers; Bénédicte Gohier, MD, PhD, Department of Psychiatry, Angers University Hospital, Angers, France.
Elodie
E
Baer
Elodie Baer, MD, Department of Medical Intensive Care and Hyperbaric Medicine, Angers University Hospital, Angers; Carole Barré, MD, Department of Psychiatry, Angers University Hospital, Angers; Carole Fleury, MD, Department of Medical Intensive Care and Hyperbaric Medicine, Angers University Hospital, Angers; Claire de Montchenu, MD, Department of Psychiatry, Angers University Hospital, Angers; Jean-Bernard Garré, MD, Department of Psychiatry, Angers University Hospital, Angers; Nicolas Lerolle, MD, PhD, Department of Medical Intensive Care and Hyperbaric Medicine, Angers University Hospital, Angers; Bénédicte Gohier, MD, PhD, Department of Psychiatry, Angers University Hospital, Angers, France.
Carole
C
Barré
Elodie Baer, MD, Department of Medical Intensive Care and Hyperbaric Medicine, Angers University Hospital, Angers; Carole Barré, MD, Department of Psychiatry, Angers University Hospital, Angers; Carole Fleury, MD, Department of Medical Intensive Care and Hyperbaric Medicine, Angers University Hospital, Angers; Claire de Montchenu, MD, Department of Psychiatry, Angers University Hospital, Angers; Jean-Bernard Garré, MD, Department of Psychiatry, Angers University Hospital, Angers; Nicolas Lerolle, MD, PhD, Department of Medical Intensive Care and Hyperbaric Medicine, Angers University Hospital, Angers; Bénédicte Gohier, MD, PhD, Department of Psychiatry, Angers University Hospital, Angers, France.
Carole
C
Fleury
Elodie Baer, MD, Department of Medical Intensive Care and Hyperbaric Medicine, Angers University Hospital, Angers; Carole Barré, MD, Department of Psychiatry, Angers University Hospital, Angers; Carole Fleury, MD, Department of Medical Intensive Care and Hyperbaric Medicine, Angers University Hospital, Angers; Claire de Montchenu, MD, Department of Psychiatry, Angers University Hospital, Angers; Jean-Bernard Garré, MD, Department of Psychiatry, Angers University Hospital, Angers; Nicolas Lerolle, MD, PhD, Department of Medical Intensive Care and Hyperbaric Medicine, Angers University Hospital, Angers; Bénédicte Gohier, MD, PhD, Department of Psychiatry, Angers University Hospital, Angers, France.
Claire
C
de Montchenu
Elodie Baer, MD, Department of Medical Intensive Care and Hyperbaric Medicine, Angers University Hospital, Angers; Carole Barré, MD, Department of Psychiatry, Angers University Hospital, Angers; Carole Fleury, MD, Department of Medical Intensive Care and Hyperbaric Medicine, Angers University Hospital, Angers; Claire de Montchenu, MD, Department of Psychiatry, Angers University Hospital, Angers; Jean-Bernard Garré, MD, Department of Psychiatry, Angers University Hospital, Angers; Nicolas Lerolle, MD, PhD, Department of Medical Intensive Care and Hyperbaric Medicine, Angers University Hospital, Angers; Bénédicte Gohier, MD, PhD, Department of Psychiatry, Angers University Hospital, Angers, France.
Jean-Bernard
JB
Garré
Elodie Baer, MD, Department of Medical Intensive Care and Hyperbaric Medicine, Angers University Hospital, Angers; Carole Barré, MD, Department of Psychiatry, Angers University Hospital, Angers; Carole Fleury, MD, Department of Medical Intensive Care and Hyperbaric Medicine, Angers University Hospital, Angers; Claire de Montchenu, MD, Department of Psychiatry, Angers University Hospital, Angers; Jean-Bernard Garré, MD, Department of Psychiatry, Angers University Hospital, Angers; Nicolas Lerolle, MD, PhD, Department of Medical Intensive Care and Hyperbaric Medicine, Angers University Hospital, Angers; Bénédicte Gohier, MD, PhD, Department of Psychiatry, Angers University Hospital, Angers, France nicolas.lerolle@univ-angers.fr.
Nicolas
N
Lerolle
Elodie Baer, MD, Department of Medical Intensive Care and Hyperbaric Medicine, Angers University Hospital, Angers; Carole Barré, MD, Department of Psychiatry, Angers University Hospital, Angers; Carole Fleury, MD, Department of Medical Intensive Care and Hyperbaric Medicine, Angers University Hospital, Angers; Claire de Montchenu, MD, Department of Psychiatry, Angers University Hospital, Angers; Jean-Bernard Garré, MD, Department of Psychiatry, Angers University Hospital, Angers; Nicolas Lerolle, MD, PhD, Department of Medical Intensive Care and Hyperbaric Medicine, Angers University Hospital, Angers; Bénédicte Gohier, MD, PhD, Department of Psychiatry, Angers University Hospital, Angers, France.
Bénédicte
B
Gohier
D000328:Adult; D005260:Female; D005602:France; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D019964:Mood Disorders / Q000453:epidemiology*; D005791:Patient Care / Q000592:standards*; D011041:Poisoning / Q000628:therapy*; D011569:Psychiatric Status Rating Scales; D012121:Respiration, Artificial / Q000706:statistics & numerical data*; D012189:Retrospective Studies; D012720:Severity of Illness Index; D013406:Suicide, Attempted / Q000523:psychology*; D011795:Surveys and Questionnaires