The Change in the Structure of Suicidal Poisonings in a Large Industrial Region (Sverdlovsk Oblast) in the Last 5 Years

• Published in: Clinical toxicology (Philadelphia, Pa.) Vol. 46; no. 5; p. 390
• Main Authors: Sentsov, V G, Brusin, K M, Yentus, V A, Novikova, O V
• Format: Journal Article
• Language: English
• Published: 01-06-2008
• ISSN: 1556-3650

Objective: The mean level of suicidal poisonings in the region is 53.2 per 100,000 population, which is several times higher then in most European countries. Such a situation triggers great concern and makes the toxicologists improve their work with the patients who survived suicidal poisonings. Methods: According to the hospitals and the office of forensic medical examination, acute poisonings were analyzed in the periods between 1997-2001 and 2002-2006 in a region of 4,350,000 population. Results: In the period between 1997-2001 the level of suicidal poisonings increased from 2170 cases (25.5%, 46.1 per 100,000) to 2593 cases (30.5%, 55.8 per 100,000); 43.3% of patients were poisoned by medicaments, 36.5% by acetic acid and 9.1% by insecticides and household chemicals. Mortality was 3%. In the period between 2002-2006 11,962 cases of self-poisoning were registered (31.8% of all poisonings), however the number of self-poisonings decreased from 2724 (34.7% of all poisonings, 58.6 per 100,000) in 2002 to 2138 (30.7% of all poisonings, 50.3 per 100,000) in 2006. For suicidal poisonings the patients used Pharmaceuticals (80%), acetic acid (8%), and insecticides (7%). 383 people died of suicide attempts in the last 5 years (3.2%), 37.7% of whom took acetic acid, 30.4% took pharmaceuticals, 31.9% took insecticides. As compared to the 1990s the number of suicidal poisonings increased, but their structure changed: the number of poisonings by acetic acid decreased, but the number of poisonings by Pharmaceuticals increased. About 55% of patients were admitted to poison centers, others were treated in local hospitals. The distinguishing feature of the acute poisonings treatment management in Sverdlovsk Oblast is that 2 of 3 poison centers are based in the major mental hospitals. There is a possibility to engage a psychiatrist 24-hours in the examination of the patients who have attempted suicide, which makes it possible to start the treatment of psychiatric pathology earlier or to discharge a patient from the hospital, if the psychiatric pathology was not identified. Thus, in Sverdlovsk regional poison center for the last 5 years 400 (16.2%) of 2468 patients, admitted to hospital after suicidal attempts, were moved to psychiatric and rehabilitation units, which deal with the treatment of depression; 28 (1.1%) were moved to narcological units. Conclusion: A great number of patients being moved from poison to psychiatric units (17.3%), and vice versa from psychiatric to poison units (2.4%) prove that it is reasonable to locate poison centers in mental hospitals.