[A prospective study on suicide attempts by self-poisoning in adolescents: Symptoms and complications]

Biological complications in adolescents' self-poisoning are not currently evaluated. The aim of this study was to describe the toxicological characteristics of suicide attempts, the ingested substances, and their complications to better prevent the risks associated with deliberate self-poisoning.

This was a descriptive, prospective, single-center study. It took place in the pediatric emergency, hospitalization, and intensive care unit of the Caen University Hospital. All children aged 10-18years who had presented to the pediatric emergency department between 1 June 2012 and 1 June 2013 for deliberate self-poisoning were included. Somatic evaluation was conducted for the protocol on arrival at the emergency room, and repeated during hospitalization, and biological evaluation was performed on arrival at the pediatric emergency unit and on the 5th day after the drug intoxication. A questionnaire was completed at this time to identify the substances ingested and the risk factors for suicide attempt.

Acetaminophen was the most frequently chosen substance compared to other drugs in acute drug overdose (P=0.01). Abdominal pain on arrival at the emergency room were significantly associated with acetaminophen (P=0.02). In 10% of the cases, a transfer to the pediatric intensive care unit was required. In total, 3.4% had acute renal failure and 3.4% acute liver failure in connection with acetaminophen ingestion. Biological complications and symptoms disappeared prior to hospital discharge. The average hospital stay was 7.1 days.

This study focused on biological complications in pediatric emergencies, but also later on deliberate self-poisoning to detect other complications. It seems important to detect the presence of liver or kidney failure, and more importantly whether there is acetaminophen ingestion. The prevention of suicide attempt recurrences also remains a priority, given the increased risk of mortality from repeating a suicide attempt. Systematization of biological assessments made in emergency situations but particularly in the hospital could improve the care of these adolescents.