THE EPIDEMIOLOGY OF DELIBERATE SELF-POISONING PRESENTING TO CHRISTCHURCH-HOSPITAL EMERGENCY DEPARTMENT

Aim. To review the recent epidemiology of deliberate self poisoning pr esentations to Christchurch Emergency Department and to compare this w ith 1992 and 1989 data. Method. A retrospective analysis of case and c omputer records over the twelve month period of 1996 was conducted and compared with published data for 1992 and 1989. Results. There were 7 13 presentations in 1996 to Christchurch Emergency Department with del iberate self poisoning, representing 1.1% (compared with 1.2% 1992; 0. 96% 1989) of total presentations. The female to male ratio was 1.9:1.0 (compared with 1.5:1.0, 2.1:1.0), 70.1% of patients presenting were u nder the age of 35. The principal drugs ingested were antidepressants 20% (compared with 24.4%; 15.7%) paracetamol (16.7% compared with 16.9 %; 10.6%) hypnotics/anxiolytics 15.6% (benzodiazepines 11.0% compared with 23.6%; 18.0%), antipsychotics 10.7% (compared with 16.1%; not rep orted). Gastric decontamination was given to 61% (compared with 73% 19 92), charcoal alone used in 54% (compared with 46%; 0.4%), gastric lav age and charcoal 7% (compared with 27%; 78%). 39% received no gastroin testinal decontamination (compared with 27% 1992). Of the patients pre senting, 68.9% were admitted (compared with 59%; 66%), 10.2% to Intens ive Care Unit (compared with 11%; 18%), There were 6 deaths (compared with 2; 2). Conclusion. Deliberate self poisoning remains a problem ma inly of the young with a gender ratio favouring female. Antidepressant medications, paracetamol, benzodiazepines and antipsychotics remain t he most common classes of drugs taken alone or in combination. An impo rtant trend within the antidepressants is the increasing misuse of sel ective serotonin reuptake inhibitors. Rates of admission to hospital a nd the Intensive Care Unit have changed but mortality rates have had n o significant change over the three time periods. Gastrointestinal dec ontamination techniques employed follow a trend towards the use of act ivated charcoal and away from gastric lavage.