Comparison of first-time and repeated self-poisoning attempts: a cross-sectional study of the associated factors in central Iran.

This study aims to identify determinants of repeated self-poisoning compared to first‑time self-poisoning at a referral poisoning center in Iran. A cross-sectional study was conducted at a referral poisoning center in Iran from January 2015 to December 2019. Demographic characteristics, toxicological data, and self-reported histories of self-poisoning behavior, self-harm, psychiatric disorders, and family history of self-poisoning were extracted from medical records. Univariable and multivariable logistic regression analyses were performed to identify factors associated with repeated self-poisoning. Out of 4256 patients, 936 (21.99%) had a history of previous self-poisoning. Females had more repeated attempts (61.2%) and fewer first-time attempts (54.5%) than males (38.8% and 45.5%, respectively) (p < 0.001). Pharmaceutical drugs accounted for the most common cause of acute poisoning (N = 666, 71.2%). Multivariable logistic regression showed that female sex (OR: 1.44, 95% CI: 1.08-1.92; p = 0.01), psychiatric disease history (OR: 3.85, 95% CI: 2.95-5.01; p<0.001), self-harm history (OR: 5.35, 95% CI: 3.70-7.77; p < 0.001), and suicide family history (OR: 2.17, 95% CI: 1.41-3.32; p < 0.001) were independent predictors of repeated self-poisoning. In this hospital-based sample of patients, it was found that female patients, having a history of psychiatric disease, self-harm and a family history of self-poisoning were predictors of repeated self-poisoning. Interventions to decrease recurrence rates for self‑poisoning should be directed towards these specific factors. However, self-poisoning that occurs in the community may be under‑represented in the data. Gender differences in self-poisoning may reflect variations in help-seeking behavior or reporting rather than true differences in recurrence risk.