One‐year follow up after admission to an emergency department for drug overdose in <scp>J</scp>apan

Ando, Shuntaro; Matsumoto, Toshihiko; Kanata, Sho; Hojo, Aya; Yasugi, Daisuke; Eto, Nobuaki; Kawanishi, Chiaki; Kasai, Kiyoto

doi:10.1111/pcn.12079

Cited by 16 publications

(12 citation statements)

References 26 publications

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“…4 We found that medicines containing barbiturates were overdosed by a substantial proportion of patients in Japan, and it was associated with serious outcomes. In a survey of all 190 patients (mean age 32.6 ± 0.95 years) who admitted to an emergency department in 1 year due to drug overdose between 2008 and 2009, 5 overdosed medicines were examined by interviewing patients and cohabitants and by urinary triage if conducted. Among 185 patients whose kinds of overdosed drugs were revealed, 29 patients (15.7%) overdosed medicines containing barbiturates.…”

mentioning

confidence: 99%

Serious outcomes associated with overdose of medicines containing barbiturates for treatment of insomnia

Ando

Yasugi

Matsumoto

et al. 2014

Psychiatry Clin Neurosci

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confidence: 99%

Serious outcomes associated with overdose of medicines containing barbiturates for treatment of insomnia

Ando

Yasugi

Matsumoto

et al. 2014

Psychiatry Clin Neurosci

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“…Forty studies were further excluded because of identical or overlapping patient samples. A total of 115 studies reporting 167 samples were included in the meta‐analysis (SM 2, Table of Included Studies, and SM 3 Data used in meta‐analysis). The samples included 46 samples of females, 46 samples of males and 75 samples of both sexes.…”

Section: Resultsmentioning

confidence: 99%

Meta‐analysis of suicide rates among people discharged from non‐psychiatric settings after presentation with suicidal thoughts or behaviours

Wang

Swaraj

Chung

et al. 2019

Acta Psychiatr Scand

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analysis of suicide rates among people discharged from non-psychiatric settings after presentation with suicidal thoughts or behaviours.Objective: To quantify the suicide rate among people discharged from nonpsychiatric settings after presentations with suicidal thoughts or behaviours. Method: Meta-analysis of studies reporting suicide deaths among people with suicidal thoughts or behaviours after discharge from emergency departments or the medical or surgical wards of general hospitals. Results: A total of 115 studies reported 167 cohorts and 3747 suicide deaths among 248 005 patients during 1 263 727 person-years. The pooled suicide rate postdischarge was 483 suicide deaths per 100 000 person-years (95% confidence interval (CI) 445-520, prediction interval (PI) 200-770) with high between-sample heterogeneity (I 2 = 92). The suicide rate was highest in the first year postdischarge (851 per 100 000 person-years) but remained elevated in the long term. Suicide rates were elevated among samples of men (716 per 100 000 person-years) and older people (799 per 100 000 person-years) but were lower in samples of younger people (107 per 100 000 person-years) and among studies published between 2010 and 2018 (329 per 100 000 person-years). Conclusions: People with suicidal thoughts or behaviours who are discharged from non-psychiatric settings have highly elevated rates of suicide despite a clinically meaningful decline in these suicide rates in recent decades. Summations• The pooled suicide rate among patients with suicidal thoughts or behaviours following discharge from a non-psychiatric setting was 483 per 100 000 person-years (95% CI 445-520).• Suicide rates were lower among samples of younger people (<25 years of age) and among more recently published studies, but were higher in the first year after discharge, among older people (>55 years of age), and men.• All patients presenting to emergency departments and general hospitals with suicidal thoughts or behaviours warrant a careful assessment and individualized treatment planning. Considerations• High between-study heterogeneity limits the extent to which the results can be regarded as generalizable.• The meta-analysis could not examine a range of clinical factors that might contribute to variation in suicide rates.• Few studies from low-and middle-income countries could be included.

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“…Intentional drug overdose was de ned as the intentional self-administration of more than twice prescribed dose of a medicine and/or over-the-counter drug at one time. 4 Recurrence was de ned as a repeated episode of an intentional overdose that required for hospitalization within 1 year of discharge. 4 Recurrence was detected from medical record when they transferred to the hospital.…”

Section: Study Setting and Patientsmentioning

confidence: 99%

“…The main predictor of future suicidal behavior is a previous suicide attempt. [3][4][5] A strategy to reduce the recurrence of suicide attempts is needed.…”

Section: Introductionmentioning

confidence: 99%

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Recurrence of Overdose Suicide Attempt Index: A Novel Scoring System for Predicting the Recurrence of Intentional Overdose

Hirose

Kasugai

Tajima

et al. 2020

Preprint

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Aim: Repeated suicide attempts through intentional overdose are not infrequent, but little is known about the risk factors for intentional overdose. We aimed to investigate risk factors for the recurrence of intentional overdose within 1 year of discharge and to develop an index that predicts recurrence.Methods: This retrospective observational study included 419 patients admitted to our hospital between 2011 and 2018 because of an intentional overdose. Of them, 43 (10.0%) repeated an overdose within 1 year of discharge. The risk factors with the highest odds ratios in multivariate logistic regression analysis were used to develop an index Recurrence of Overdose Suicide Attempt. The predictive value of this index for recurrence was compared with that of the existing SAD PERSONS scale.Results: The following variables were significantly associated with recurrence and were included in the index: anxiety and/or insomnia at discharge; use of five or more psychotropic drugs; a neurotic, stress-related, or somatoform disorder; and female sex (odds ratios: 4.24; 5.52; 2.41; and 3.41, respectively). The newly developed index was a significantly better predictor of recurrence than the SAD PERSONS scale (area under the receiver operating characteristics curve, 0.797 vs. 0.668; p = 0.007). Sensitivity, specificity, and positive and negative predictive values for Recurrence of Overdose Suicide Attempt > 4 points (out of 6) were 72.1%, 75.8%, 25.4%, and 96.0%, respectively.Conclusion: The novel index can predict the recurrence of intentional overdose with a good negative predictive value and may therefore be a useful screening tool for this high-risk population.

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One‐year follow up after admission to an emergency department for drug overdose in Japan

Cited by 16 publications

References 26 publications

Serious outcomes associated with overdose of medicines containing barbiturates for treatment of insomnia

Serious outcomes associated with overdose of medicines containing barbiturates for treatment of insomnia

Meta‐analysis of suicide rates among people discharged from non‐psychiatric settings after presentation with suicidal thoughts or behaviours

Recurrence of Overdose Suicide Attempt Index: A Novel Scoring System for Predicting the Recurrence of Intentional Overdose

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