title: Adolescent deliberate self-poisoning in South-East Melbourne.
abstract: OBJECTIVE
  To describe the characteristics of adolescents presenting with deliberate self-poisoning (DSP) to a large Australian healthcare network.
  
  
  METHODS
  This is a retrospective chart review of 12-17 year olds presenting to three Monash Health EDs with self-poisoning from January 2012 to December 2014.
  
  
  RESULTS
  There were 35 207 adolescent presentations in the study period. A total of 721 cases were for DSP (2%), and 501 (1.4%) presented with recreational or accidental self-poisoning. The most common DSP toxicants were paracetamol (28%), non-steroidal anti-inflammatory agents (15%) and serotonin reuptake inhibitors (10%). Of the DSP presentations, 96% were impulsive events; 23% of patients (n = 129) presented on multiple occasions, and 67% of all DSP cases had a past psychiatric history, particularly depression (57%). Disposition for DSP patients included 60% discharged home, 6% short stay unit, 19% medical admission, 13% psychiatric admission and 2% intensive care unit admission. There were no mortalities.
  
  
  CONCLUSIONS
  Adolescent DSP presentations frequently involved impulsive ingestion of over-the-counter medications, suggesting less access to prescription medications. Additionally, pre-existing mental health history and re-presentation were common. Initiatives to prevent DSP might include an increased focus on the early identification and management of mental health problems in adolescents in the community.
authors.affiliation: Emergency Department, Monash Children's Hospital, Melbourne, Victoria, Australia.
authors.forename: Mandira
authors.initials: M
authors.lastname: Hiremath
authors.affiliation: Emergency Department, Monash Children's Hospital, Melbourne, Victoria, Australia.|Department of Medicine, School of Clinical Sciences at Monash Health, Monash University, Melbourne, Victoria, Australia.|Murdoch Children's Research Institute, Melbourne, Victoria, Australia.
authors.forename: Simon
authors.initials: S
authors.lastname: Craig
authors.affiliation: Department of Medicine, School of Clinical Sciences at Monash Health, Monash University, Melbourne, Victoria, Australia.|Monash Clinical Toxicology Service, Program of Emergency Medicine, Monash Health Dandenong Hospital, Melbourne, Victoria, Australia.
authors.forename: Andis
authors.identifier: http://orcid.org/0000-0002-0310-3983
authors.initials: A
authors.lastname: Graudins
mesh_terms: D000293:Adolescent; D001315:Australia / Q000453:epidemiology; D002648:Child; D062787:Drug Overdose / Q000453:epidemiology*; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D004366:Nonprescription Drugs / Q000506:poisoning*; D055553:Prescription Drugs / Q000506:poisoning*; D012189:Retrospective Studies; D013406:Suicide, Attempted / Q000706:statistics & numerical data*
chemical_list: D004366:Nonprescription Drugs; D055553:Prescription Drugs
keywords: adolescent; deliberate self-harm; drug overdose; poisoning