Characteristics of Drugs Ingested for Suicide Attempts in the Elderly

Abstract

BackgroundSuicide is a significant public health problem worldwide. Suicide rates among elderly persons (≥ 65 years of age) are three times higher than those of younger people in Korea. The emergency department is an important entry of drug-related suicide attempt patients. In this study, we compared the frequency of drug types by age subgroup. Furthermore, we provide suggestions for preventing suicide attempts in the elderly.MethodsWe investigated 433 patients who were admitted to the emergency department for drug-related suicide attempts between 1 May 2015 and 30 April 2017.ResultsThe proportion of patients who overdosed on antidepressants was 32.5% in the non-elderly age group and 8.0% in the elderly group (≥ 65 years of age) (P < 0.001). Among the elderly, the most commonly ingested agent was hypnotics (59.1%) (P < 0.001). Compared with the non-elderly, the results showed that the elderly used fewer antidepressants (P < 0.001) and analgesics (P < 0.001). Meanwhile, the elderly used more hypnotics (P < 0.001). Over-the-counter drugs and other medications showed similar usage trends in both age groups (P = 0.664, P = 0.193).ConclusionThe categories of drugs ingested for suicide attempts vary widely between different age groups. Younger people used antidepressants more frequently in suicide attempts, while the elderly used hypnotics more frequently. And the elderly required longer hospital stays. Suicide ideation and depressive mood in older patients who are prescribed hypnotics for various reasons should not be neglected. Further prevention efforts are needed to prevent suicide among the elderly.

The Characteristics of Elderly Individuals Who Attempted Suicide by Poisoning: a Nationwide Cross-sectional Study in Korea

“…All these poor outcomes were consistent with previous studies, which implied more distinct suicide intent or lower physical resilience among the elderly. 15,20,21 There are some variations in the frequency of self-administered poisons. Two studies conducted in Australia reported that benzodiazepine was the most commonly ingested drug for poisoning by elderly patients.…”

“…All these poor outcomes were consistent with previous studies, which implied more distinct suicide intent or lower physical resilience among the elderly. 15 20 21 …”

“… 21 22 Other studies conducted in a single medical center in Korea showed that the most commonly ingested drugs among elderly patients were hypnotics (59.1%) and psychotropics (54.6%), respectively. 15 20 However, when expanding the scope of the self-administered poison to drugs, a 5-year observational study in Korea reported that the most common self-administered substance was pesticides in male patients and sedative-hypnotics in female patients. 23 Our results also showed that the proportion of those who self-administered pesticides increased with age, and accordingly, the mortality rate in the elderly was higher than in the younger patients.…”

“…14 One study conducted in Korea reported that among drug-related suicide attempts, the elderly used hypnotics more frequently, and had a higher admission rate and required longer hospital stays. 15 Because the ED is the first place where medical intervention takes place after suicide attempts, it is important to provide adequate medical assistance in the ED to those who attempted suicide. 16 Korea has been providing an ED-based case management program for people who attempt suicide since 2013.…”

Indicators of early hospitalization decision to shorten emergency department length of stay of suicide attempters

“…The emergency department (ED) is the rst location where suicide attempters are brought when primary care institutions or outpatient clinics are inaccessible [4]. Patients with physical injuries or altered mental status, besides psychiatric issues, inevitably tend to visit the ED [5]. The hospitals and EDs are readily accessible through South Korea's universal healthcare system [6].…”