<p>Clinical Characteristics of Pesticide Self-Harm as Associated with Suicide Attempt Repetition Status</p>

Abstract

Purpose: Previous suicide behavior predicts future suicide risk. Studies of suicide repetition are important for suicide prevention. This study examined the clinical characteristics and psychiatric comorbidities of pesticide self-harm as associated with suicide attempt repetition status. Patients and Methods: This retrospective, observational study included patients admitted to a medical center in northern Taiwan between 2000 and 2015 following suicide attempts by pesticide. Diagnoses were made by a consultation-liaison psychiatry team based on the DSM IV-TR criteria. Independent samples t-test was used to analyze the quantitative variables and Pearson's Chi-squared test with a Bonferroni adjustment for categorical variables. Univariate binary logistic regression analysis was conducted to determine the predictors for repeated suicide attempt and multivariate binary logistic regression analysis to identify significant associated factors. Results: Among 151 patients, organophosphate pesticides were the most used (80.8%). The average age was 52.9±17.2 years. Most patients were married males from rural areas, with depressive disorder most often diagnosed (40.4%). Nearly one-third of them were suicide repeaters (n=43, 28.5%); these patients were less likely to be married (53.5%, p=0.001), had previously used psychiatric services (72.1%, p<0.001) and chose complex suicide (46.5%, p=0.014) more often compared to nonrepeaters. No significant differences were found between repeaters and nonrepeaters regarding psychiatric comorbidities. Multivariate logistic regression analysis revealed that marital status (odds ratio: 2.916, 95% confidence interval: 1.234-6.891, p=0.015) and previous psychiatric services usage (odds ratio: 6.897, 95% confidence interval: 3.012-15.625, p<0.001) were significant risk factors associated with suicide repetition. Conclusion: Pesticide suicide repeaters were characterized by less likely to be married and more likely to use psychiatric services before suicide attempts. These features help ensuring that the needs of people who have made a suicide attempt are addressed, and it reduces the likelihood of repetition.

The role of alcohol use in pesticide suicide and self-harm: a scoping review

“…higher dose of alcohol consumed led to higher amount of OP ingested and increased the likelihood of death Gawarammana et al (Sri Lanka) [ 63 ] Clinical effects and toxicokinetics of bispyribac self-poisoning Cohort Two general hospitals 110 patients with bispyribac poisoning Acute 14.5% of patients had co-ingested alcohol. Of the three patients who died, two had co-ingested alcohol Huang et al (Taiwan) [ 64 ] Clinical and psychiatric characteristics of self-harm with OP, carbamates, or glyphosates Cohort One hospital 151 self-poisoning cases who received a psychiatric evaluation Acute and chronic Alcohol intoxication assessed for complex suicides (> 1 method) of which 54.2% were recorded as alcohol intoxicated, this was similar for repeated (55%) and non-repeated self-harm (53%). Among all patients who were assessed, 25.8% had alcohol use disorder, which was higher among repeaters (34.9%) than non-repeaters (22.2%) (NS) Kim and Lee (Republic of Korea) [ 65 ] Co-ingestion of alcohol in self-poisoning (any poison) Cohort One general hospital 286 deliberate self-poison patients Acute 64% of the sample had co-ingested alcohol.…”

“…One study of patients presenting to a medical centre in Taiwan only included complex suicide cases (i.e. cases with at least one other means in addition to pesticides), of whom more than half (54%) had ‘alcohol intoxication’ (assessment method not reported) with no significant difference between those with and without previous events of self-harm (‘suicide attempts’) [ 64 ]. A Sri Lankan study across three hospitals was the only study that assessed BAC and found that more than half of patients (51%) had a BAC ≥ 0.05 mg/dL and a median of 0.15 mg/dL [ 60 ].…”

“…In a Sri Lankan study, among participants who underwent a mental health module, 10% had probable alcohol dependence (DSM-IV), with an OR for probable alcohol dependence of 5.26 (95% CI 1.06–26.11), compared to controls [ 74 ]. In a hospital-based study from Taiwan, 26% of assessed patients were reported to have an AUD (DSM), with no significant difference between those who had a first and subsequent self-harm event [ 64 ]. A similar proportion was observed in a sample of patients in a general medicine ward in Kerala, India, where 23% of patients presenting at a general medicine ward had alcohol dependence, as per ICD-10 [ 70 ].…”

Human Poisoning with Chlorpyrifos and Cypermethrin Pesticide Mixture: Assessment of Clinical Outcome of Cases Admitted in a Tertiary Care Hospital in Taiwan

“…Pesticide self-poisoning is a widely used means of suicide, and one of the most popular approaches of suicide worldwide. 37 It comprises an important public health issue in Asian nations. 38 Suicide by intentional ingestion of pesticides is common in Taiwan because of easy access.…”