Self-poisoning with medications in adolescents: a national register study of hospital admissions and readmissions

Elin Anita Fadum; Barbara Stanley; Ping Qin; Lien My Diep; Lars Mehlum

doi:10.1016/j.genhosppsych.2014.09.004

Self-poisoning with medications in adolescents: a national register study of hospital admissions and readmissions

Gen Hosp Psychiatry. 2014 Nov-Dec;36(6):709-15. doi: 10.1016/j.genhosppsych.2014.09.004. Epub 2014 Sep 9.

Authors

Elin Anita Fadum¹, Barbara Stanley², Ping Qin³, Lien My Diep⁴, Lars Mehlum³

Affiliations

¹ National Centre for Suicide Research and Prevention, Institute of Clinical Medicine, University of Oslo, Norway. Electronic address: fadumelin@gmail.com.
² National Centre for Suicide Research and Prevention, Institute of Clinical Medicine, University of Oslo, Norway; Department of Psychiatry, Columbia University College of Physicians and Surgeons, New York, NY, USA; Molecular Imaging and Neuropathology Division and Suicide Prevention Training, Implementation and Evaluation Program in the Center for Practice Innovation, New York State Psychiatric Institute, New York, NY, USA.
³ National Centre for Suicide Research and Prevention, Institute of Clinical Medicine, University of Oslo, Norway.
⁴ National Centre for Suicide Research and Prevention, Institute of Clinical Medicine, University of Oslo, Norway; Department of Biostatistics, Epidemiology and Health Economics, Oslo University Hospital, Norway.

PMID: 25307514
DOI: 10.1016/j.genhosppsych.2014.09.004

Abstract

Objective: To examine characteristics of hospital admissions and risk factors associated with rehospitalization for self-poisoning with medications in adolescents aged 10-19 years.

Method: This study used data from the Norwegian Patient Register from 2008 to 2011. The main outcome was hospital readmission within the observation period. A complementary log-log regression model was used to assess the effect of characteristics at index hospital admission on readmission.

Results: Of 1497 patients, 76.4% were females and 89.8% were aged 15-19 years. At their first hospital admission, about one third received a secondary psychiatric diagnosis. Females (47.5%) were registered with an E-code for intentional self-harm more often than males (33.7%), and females were more often than males discharged to further treatment (27.8% vs. 21.5%). As many as 18.4% were rehospitalized for self-poisoning by medications. Significant predictors for hospital readmission were female sex [hazard ratio (HR) = 2.4, 95% confidence interval (CI) 1.7-3.6], discharge to further treatment (HR = 2.3, 95% CI 1.8-2.9) and psychiatric secondary diagnoses (HR = 1.5, 95% CI 1.2-1.9).

Conclusion: This national study demonstrated significant sex differences in adolescents treated in hospital for self-poisoning with medications. Psychiatric secondary diagnoses had a strong predictive effect on readmission, which indicates the importance of psychiatric/psychosocial assessment of adolescents who are admitted to hospital for self-poisoning with medications.

Keywords: Adolescent; Emergency health services; Poisoning; Self-injurious behavior; Self-poisoning.

MeSH terms

Adolescent
Adult
Child
Emergency Medical Services / statistics & numerical data*
Female
Humans
Male
Mental Disorders / epidemiology*
Norway / epidemiology
Patient Readmission / statistics & numerical data*
Registries / statistics & numerical data*
Self Medication / statistics & numerical data*
Self-Injurious Behavior / epidemiology*
Sex Factors
Suicide, Attempted / statistics & numerical data
Young Adult