Effects of a drug overdose in a television drama on presentations to hospital for self poisoning: time series and questionnaire study

Objectives To determine whether a serious paracetamol overdose in the medic al television drama Casualty altered the incidence and nature of general ho spital presentations for deliberate self poisoning. Design Interrupted time series analysis of presentations for self poisoning at accident and emergency departments during three week periods before and after the broadcast. Questionnaire responses collected from self poisoning patients during the same periods. Setting 49 accident and emergency departments and psychiatric services in U nited Kingdom collected incidence data; 25 services collected questionnaire data Subjects 4403 self poisoning patients; questionnaires completed for 1047. Main outcome measures Change in presentation rates for self poisoning in th e three weeks after the broadcast compared with the three weeks before, use of paracetamol and other drugs for self poisoning, and the nature of overd oses in viewers of the broadcast compared with non-viewers. Results Presentations for self poisoning increased by 17% (95% confidence i nterval 7% to 28%) in the week after the broadcast and by 9% (0 to 19%) in the second week. Increases in paracetamol overdoses were more marked than i ncreases in non-paracetamol overdoses. Thirty two patients who presented in the week after the broadcast and were interviewed had seen the episode-20% said that it had influenced their decision to take an overdose, and 17% sa id it had influenced their choice of drug. The use of paracetamol for overd ose doubled among viewers of Casualty after the episode (rise of 106%; 28% to 232%). Conclusions Broadcast of popular television dramas depicting self poisoning may have a short term influence in terms of increases in hospital presenta tion for overdose and changes in the choice Of drug taken. This raises seri ous questions about the advisability of the media portraying suicidal behav iour.