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Table of Contents
ORIGINAL ARTICLE
Year : 2020  |  Volume : 17  |  Issue : 2  |  Page : 70-72

Patterns of self-intoxication among inpatients in Benghazi medical center – Libya


1 Department of Endocrine, Faculty of Medicine, Benghazi University, Benghazi, Libya
2 Department of Internal Medicine, Faculty of Medicine, El-Mergib University, Al Khums, Libya
3 Department of Medicine, Jamhoriya Hospital, Benghazi, Libya

Date of Submission25-Apr-2020
Date of Acceptance05-May-2020
Date of Web Publication18-Jun-2020

Correspondence Address:
Khaled D Alsaeiti
Department of Medicine, Jamhoriya Hospital, Benghazi
Libya
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/am.am_25_20

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  Abstract 


Background: Self-harm is a major public health concern, with community studies reporting a lifetime risk of 13%–18%, it is a key risk factor for suicide, and it is important to have contemporary information on the extent of risk and is relatively common among young people with prevalence rates in adolescent samples which range from 6.9% to 15.9%. One review of the literature showed that 13.2% of adolescents reported engaging in self-harm at some stage in their lives. The aim of this study was to describe the characteristics patterns of self-intoxication patients and their response to psychiatric consultation. Patients and Methods: This observational single-center study involved prospective review of all patients whom admitted to the Medical Department at Benghazi Medical Center over a 12-month period from January 2017 to December 2017 after self-intoxication. Self-intoxication with suicidal intent was assessed in the emergency department after questioning of the patient and relatives. Data included were age, sex, marital status, employment, type and source of drugs or toxins, and whether the material was taken intentionally or accidentally. Patients who were considered to have an accidental overdose or drug mistake were not included in the study. Results: Sixty-six patients were identified, 53 (80%) were females with a mean age of 23 years, 49 (74%) were single, and all males were jobless and school-leavers. Twenty-nine (55%) females were homemakers, 19 (36%) were students, and 9% were working. Fifty-seven (86%) get the drugs from their home, 9 (14%) bought from the market, 55 (83%) took the drug intentionally, and 11 (17%) accidentally. Thirty (45%) used drugs as toxins, 22 (33%) insecticides, 10 (5%) rat killers, and 4 (6%) other types of toxins. Nine (14%) were admitted to the intensive care unit, 38 (58%) refused any psychiatric consultation. Conclusions: Causes are associated with both individual and socioeconomic parameters, such as relationships among family members, unemployment, insufficient education, and drug misuse. Due to the repeated drug intoxication events, it is obvious that these persons definitely need psychiatric help and support.

Keywords: Self-intoxication, suicide, overdose


How to cite this article:
Elsaeiti MS, Alkhumsi SI, Alsaeiti KD. Patterns of self-intoxication among inpatients in Benghazi medical center – Libya. Apollo Med 2020;17:70-2

How to cite this URL:
Elsaeiti MS, Alkhumsi SI, Alsaeiti KD. Patterns of self-intoxication among inpatients in Benghazi medical center – Libya. Apollo Med [serial online] 2020 [cited 2020 Jul 8];17:70-2. Available from: http://www.apollomedicine.org/text.asp?2020/17/2/70/287084




  Introduction Top


Self-harm is a major public health concern, with community studies reporting a lifetime risk of 13%–18%,[1] it is a key risk factor for suicide, and it is important to have contemporary information on the extent of risk [2] and is relatively common among young people with prevalence rates in adolescent samples which range from 6.9% to 15.9%.[3] One review of the literature showed that 13.2% of adolescents reported engaging in self-harm at some stage in their lives.[4]

Voluntary drug intoxication is a major medical and social problem in most countries all over the world. It is expected to be 10–20 times more frequent than suicide. Conventionally, it has been more common among females than males, but some recent studies showed similar rates across genders and even higher rates among males.[5] The incidence varies from 4% in Taiwan [6] to 13.8% in Australia.[7]

The objective of the present article is to record all cases of drug intoxication defined as voluntary drug overdosing or taking of toxic substances voluntarily, hospitalized to the medical department. Moreover, we have studied the incidence rate and distribution in terms of age, gender, marital status, employment, type of toxic substance, outcome, and the causes. The aim of this study was to describe the characteristics patterns of self-intoxication patients and their response to psychiatric consultation.


  Patients and Methods Top


This was a observational prospective single-center study in which all patients admitted to the Medical Department at Benghazi Medical Center because of voluntary drug or any other toxin intake as suicidal attempt from January 2017 to December 2017, based on history taken from the patient or his relatives and clinical findings of side effect of the toxin. For each patient, the following data were obtained: age, gender, marital status, employment, type and source of drug or toxin, and whether it was taken intentionally or accidentally.


  Results Top


Sixty-six patients were identified, 53 (80%) were females, with a mean age of 23 years (range: 13–40 years) [Figure 1], 49 (74%) were single, and all males were jobless and school-leavers. Twenty-nine (55%) females were homemakers, 19 (36%) were students, and 5 (9%) were working [Table 1]. Fifty-seven (86%) get the drugs from their home, and 9 (14%) bought from the market. Fifty-five (83%) took the drug intentionally, 11 (17%) accidentally. Thirty (45%) used drugs as toxins, 22 (33%) insecticides, 10 (5%) rat killers, and 4 (6%) other types of toxins. Nine (14%) were admitted to the intensive care unit, 38 (58%) refused any psychiatric consultation, and there were no deaths.
Figure 1: Gender distribution of sample

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Table 1: Distribution of patient according to occupation

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  Discussion Top


This is the second study on the pattern of acute poison and drug self-intoxication among adults in Libya to the best of our knowledge. In the present study, the male-to-female ratio was 1:4, which was higher than the study conducted by Roaid 1:2.9[8] and Tountas et al. 1:1.92.[9] Most cases of drug intoxication (74%) were single women, and married women who received secondary education. The causes mainly conflict with other family members or husbands. The fact that the females prevail is related to their personality, emotional features, and the idiosyncrasy of women. All males were jobless, due to the high unemployment rate, the indication is that employment plays an important role in ensuring a normal mental status, these results were the same as that of Tountas et al.[9] Most of the patients were admitted in May and June at the time of final school examinations. In comparison with other studies, the drugs taken are quite similar, but in general, there are differences in the drugs preferred by admitted persons for intoxication. In our study, paracetamol, nonsteroidal anti-inflammatory drugs, and antibiotics are the most drugs chosen, while Roaid [8] found that psychotropic and oral hypoglycemics are the main drugs chosen. On the contrary, in the United Kingdom, paracetamol either alone or in combination with other drugs is the drug used mostly in attempted suicide.[10] Other drugs which used by our patients are insecticides and rat killer. Most of the patients got the drug either from their own homes or by buying it from the market, which they are not difficult to obtain. No deaths were recorded throughout the study. The fact that the clinical state of most cases attempting suicide is good when admitted to the hospital, and most of them recover without any medical complications indicate that most of them seeking family attention.[11] Fifty-eight percent of patients refused psychiatric consultation, we thought it is because of the cultural background of the stigma of psychiatric illness, especially in females.


  Conclusions Top


Drug intoxication is a problem that occurs frequently with medical as well as social aspects. The increased use of drugs from home in self-intoxication is an alarming signal, and caution in their housekeeping seems to be indicated. Causes are associated with both individual and socioeconomic parameters, such as relationships among family members, unemployment, insufficient education, drug misuse, and due to the repeated drug intoxication events, it is obvious that these persons definitely need psychiatric help and support.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
  References Top

1.
Kidger J, Heron J, Leon DA, Tilling K, Lewis G, Gunnell D. Self-reported school experience as a predictor of self-harm during adolescence: A prospective cohort study in the South West of England (ALSPAC). J Affect Disord 2015;173:163-9.  Back to cited text no. 1
    
2.
Hawton K, Bergen H, Cooper J, Turnbull P, Waters K, Ness J, et al. Suicide following self-harm: Findings from the multicentre study of self-harm in England, 2000-2012. J Affect Disord 2015;175:147-51.  Back to cited text no. 2
    
3.
McMahon EM, Reulbach U, Corcoran P, Keeley HS, Perry IJ, Arensman E. Factors associated with deliberate self-harm among Irish adolescents. Psychol Med 2010;40:1811-9.  Back to cited text no. 3
    
4.
Evans E, Hawton K, Rodham K, Deeks J. The prevalence of suicidal phenomena in adolescents: A systematic review of population-based studies. Suicide Life Threat Behav 2005;35:239-50.  Back to cited text no. 4
    
5.
The 28th World Congress of the International Association for Suicide Prevention (IASP 2015), Montreal, Canada; 2015. p. 16-20.  Back to cited text no. 5
    
6.
Lin SH, Lin MS. A survey on drug-related hospitalization in a community teaching hospital. Int J Clin Pharmacol Ther Toxicol 1993;31:66-9.  Back to cited text no. 6
    
7.
Henderson A, Wright M, Pond SM. Experience with 732 acute overdose patients admitted to an intensive care unit over six years. Med J Aust 1993;158:28-30.  Back to cited text no. 7
    
8.
Roaid RB. Fatal and non-fatal acute poisoning an analysis of 193 cases. JMJ 2003;2:56-7.  Back to cited text no. 8
    
9.
Tountas C, Sotiropoulos A, Skliros SA, Kotsini V, Peppas TA, Tamvakos E, et al. Voluntary self-poisoning as a cause of admission to a tertiary hospital internal medicine clinic in Piraeus, Greece within a year. BMC Psychiatry 2001;1:4.  Back to cited text no. 9
    
10.
Keul HG, Schäfer V, Lörcher U, Schneider M, Lutz FU, Reuhl J. Preliminary results of an interdisciplinary survey of drug victims. Forensic Sci Int 1993;62:147-9.  Back to cited text no. 10
    
11.
Caravati EM, McElwee NE. Use of clinical toxicology resources by emergency physicians and its impact on poison control centers. Ann Emerg Med 1991;20:147-50.  Back to cited text no. 11
    


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