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Prescribed medication availability and deliberate self-poisoning: a longitudinal study.

Bergljot Gjelsvik¹, Fridtjof Heyerdahl, Keith Hawton

¹Department of Psychology, University of Oslo, Oslo, Norway. bergljot.gjelsvik@psykologi.uio.no

The Journal of Clinical Psychiatry

|May 15, 2012

Summary

Patients with deliberate self-poisoning (DSP) have significantly more prescribed medications. Most DSP patients use their own collected medications, highlighting the importance of managing total medication load for self-harm risk.

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Area of Science:

Pharmacology
Psychiatry
Public Health

Background:

Prescribed medication availability for deliberate self-poisoning (DSP) patients is unknown.
It is unclear if DSP patients utilize their prescribed drugs for self-poisoning episodes.

Purpose of the Study:

To compare prescribed medication availability in DSP patients versus the general population.
To determine if DSP patients use their prescribed medications during self-poisoning events.
To identify differences between patients who ingest prescribed medication and those who do not.
To analyze the time between last medication collection and DSP episodes.

Main Methods:

Longitudinal study design.
Inclusion of 171 patients admitted for DSP across 3 hospitals in Eastern Norway (Jan 2006 - Mar 2007).
Prescription data retrieved from the Norwegian Prescription Database for 22.5 months prior to admission.

Main Results:

DSP patients possessed a substantially higher prescribed medication load (mean 30 prescriptions/year) compared to the general population.
77.2% of DSP patients ingested their own collected medications.
25% used medications collected within the week prior to admission.
Ingestion of collected drugs increased with age; sedatives were more likely used for self-poisoning than antidepressants.

Conclusions:

DSP patients' high medication load is significant due to their propensity to use these drugs for self-poisoning.
Total medication load, rather than timing of collection, is a key factor in self-poisoning incidents.
Increased attention to the overall medication burden of individuals at risk for self-harm is warranted.