Self‐harm by single‐ and multi‐agent medication poisoning in a retrospective analysis of a Poison Control Center database from January 2018 to December 2022

Abstract

PurposeMedication poisoning is the most common method of self‐harm. Longitudinal studies incorporating pre‐ and post‐COVID‐19 pandemic data are required to describe the phenomenon and to evaluate the long‐term impact on mental health.MethodsCalls to the Poison Control Center of Policlinico Umberto I Hospital ‐ Sapienza University of Rome, Italy, were analyzed retrospectively for characteristics and clinical presentation of cases of interest from January 2018 to December 2022.ResultsA total of 756 cases of self‐harm by medication poisonings were recorded in the study period. A reduction in rate of cases in 2020 was followed by a return to pre‐pandemic levels by 2021. When separately analyzing single‐ and multi‐agent cases, occurrence of cases involving just one medication increased since early 2021, with a peak in 2022 (7.8% of total calls, 95% CI 6.2–9.5, from 4.9%, 95% CI 4.1–5.8 in 2018). This increase in the rate of cases, mostly of none or mild severity, was driven by youth aged 12–21, in which the relative proportion of single‐ versus multi‐agent cases showed an increasing trend since 2020 (from 42.6% in 2018 to 78.6% in 2022). Acetaminophen was the medication most frequently involved and benzodiazepines the largest class. A psychiatric background was increasingly seen in 2022, especially in age group 12–21.ConclusionSingle‐agent medication self‐harm may be an increasingly prevailing phenomenon. Young adolescents with a psychiatric background might be most vulnerable to this behavior in the COVID‐19 pandemic aftermath. Healthcare professionals should expect favorable clinical outcome and improve both counseling and psychotherapy supervision in individuals at risk.