Deliberate self-poisoning in adolescents

Adolescent suicide has become increasingly more prevalent in recent years, with self-poisoning being a frequent means of suicide attempt.

To investigate the factors associated with adolescent self-poisoning.

Data on adolescents referred for intentional self-poisoning to the Adolescent Medical Unit during the years 1990-1998 were evaluated retrospectively. Data were obtained from the hospital medical records and included the following factors: sociodemographic data, educational status, agent and route of intake, motivation for overdose, and the extent of serious suicidal intent.

We evaluated 324 cases of adolescent self-poisoners aged 12-18 years (mean +/- SD 14.8 +/- 1.5 years). The female/male ratio was 8:1. Most of the patients were attending school and lived in urban areas. Oral ingestion was the only route of intake; 84.5% of the patients ingested drugs and 10.5% non-medicinal compounds. The drug most commonly taken was acetaminophen. The non-medicinal compounds were mostly pesticides and household materials. The suicide attempts were most frequently associated with transient depression, stemming from defects in child-family communication. As based on clinical psychiatric evaluation, patients who had ingested polydrugs and non-medical compounds evidenced a significantly greater suicidal intent (chi 2 = 11.9, P < 0.001) compared to those who took only one or two kinds of drugs.

We found that self-poisoning attempts occur most frequently in depressed females at junior high and high school, usually in the context of family dysfunction. Non-medicinal agents and polydrug ingestion are major risk factors for evaluating the seriousness of the suicidal intent.