Psychological disturbances in adolescents with acute voluntary poisoning

Abstract

Objective. The present study has two main objectives: to evaluate the psychological characteristics of adolescents with voluntary acute poisoning in a pediatric toxicology department and to estimate the role of psychological evaluation in the management of these patients. Material and method. The study includes the retrospective analysis of all patients with voluntary acute intoxication, admitted to our clinic between October 1, 2017 and September 30, 2018. The following criteria were considered: age, gender, number of hospitalizations with this diagnosis and psychological evaluation. performed during hospitalization. Results. During the mentioned period, in the Toxicology and Intensive Care Department of the Emergency Clinical Hospital for Children "Grigore Alexandrescu" in Bucharest, 181 patients were admitted with the diagnosis of voluntary acute poisoning, aged between 10 and 18 years. There was a similar percentage of girls compared to boys (58.1% compared to 41.9%), and most patients (n = 137, 75.7%) were from urban areas. Of the total number of patients 22 (12.1%) had two or more hospitalizations with the diagnosis of voluntary acute intoxication. In 13 cases (7.2%), patients were known to have previous psychiatric disorders: 8 patients with depression, 2 with behavioral disorder and 3 with disorders associated with chronic substance abuse. Analyzing the results of the psychological evaluation in these patients we found that the main psychological disorder was the emotional reaction, being identified in 98 patients (54.1%). The suicide attempt was identified in only 31 patients (17.1%) of whom only 10 received the transfer recommendation in a psychiatric clinic. Conclusions. Psychological evaluation of patients with acute voluntary intoxication is essential during hospitalization in the toxicology section to identify real psychological problems. Emotional reaction is the main psychological disorder in patients with acute voluntary intoxication. The actual suicide attempt is found only in a relatively small number of patients, in our study being diagnosed only at 17% of the total voluntary acute poisoning.

Characteristics of suicidal poisoned patients admitted to tertiary care center during COVID-19 pandemic

“…Compared to the accidental group in the current study, the suicidal poisoning group had a significant association with a history of psychiatric illness (19.4% versus 5.3%, p = 0.033) and therapeutic psychiatric drug administration (16.2% versus 2.6%, p = 0.027). These findings are harmonious with the results of previous researchers [34,35] who revealed that 13% and 31.6% of suicidal poisoned patients, respectively, had pre-existing psychiatric disorders. Nistor and colleagues [36] also concluded that psychological disturbance increases the risk of suicidal poisoning by 11% to 27% more than the overall population.…”

“…This result was in concurrence with Dedic and colleagues [ 53 ], who recorded that the HAM-D scores were moderate-to-severe in suicidal poisoning subjects, while mild in controls. Furthermore, Nitescu and colleagues [ 34 ] noticed that depression represented 36.1% of common psychiatric disorders among adolescents with suicidal poisoning. Similarly, a previous research in China [ 54 ] concluded that more than half of their included subjects had moderate-to-severe degrees of both anxiety and depression during the COVID-19 pandemic.…”