CURRENT ASPECTS OF PARASUICIDAL INTOXICAT IONS

Background: The study was designed to evaluate critically the backgrou nd, findings and outcome in patients who have carried out suicidal and parasuicidal acts. Patients and Methods: All parasuicidal patients wh o were admitted to the Departement of Medicine of the University of Ma inz over a period of 1 year were investigated. The basic data of all p atients was documented (time of the parasuicidal act, stay in hospital , clinical parameters, psychiatric appraisals and therapy instituted). The semistructured interview ''European Parasuicide Study interview S chedule (EPSIS)'' of the WHO/EURO was used to record the psychosocial background. Results: The 153 patients were mostly suffering from intox ications with sedatives and psychoactive agents: they comprised 53 mal e (35%) and 100 female (65%) patients. The average age was 36 years. E ighty-two suicide patients were treated in the emergency admission sec tion and 65 in intensive-care units. The duration of treatment in the emergency admisssion section averaged 9 hours, as compared to about 6 days on the intensive-care unit. Extracentral effects were most promin ent amongst the ''sequelae'' of intoxications. Discharged directly to their homes were 58%, 31% to psychiatric hospitals and 9% to general w ards; 2% died. The primary elimination of poison was achieved by induc ed vomiting in 40% of the cases, and by pumping out the stomach in 23% . There were no serious clinical alterations of clinical test paramete rs. Artificial ventilation was required in 8%. 107 suicide cases (61%) investigated psychiatrically showed moderate (41%) and severe (20%) p sychological abnormalities. Depressive syndrome (35%, of these 1 third with major depression), which frequently occurred in the context of a n acute stress reaction, predominated amongst the diagnoses. Forty-two patients could be interviewed 6 days after suicide or parasuicide. Of those 90% interviewed had visited their family doctor in the course o f the year before the current admission. Thirty-one patients had alrea dy received outpatient therapy and 15 had undergone an inpatient form of psychiatric therapy.