[Current aspects of para-suicidal poisoning].

BACKGROUND

The study was designed to evaluate critically the background, findings and outcome in patients who have carried out suicidal and parasuicidal acts.

PATIENTS AND

METHODS

All parasuicidal patients who were admitted to the Department of Medicine of the University of Mainz over a period of 1 year were investigated. The basic data of all patients was documented (time of the parasuicidal act, stay in hospital, clinical parameters, psychiatric appraisals and therapy instituted). The semistructured interview "European Parasuicide Study Interview Schedule (EPSIS)" of the WHO/EURO was used to record the psychosocial background.

RESULTS

The 153 patients were mostly suffering from intoxications with sedatives and psychoactive agents: they comprised 53 male (35%) and 100 female (65%) patients. The average age was 36 years. Eighty-two suicide patients were treated in the emergency admission section and 65 in intensive-care units. The duration of treatment in the emergency admission section averaged 9 hours, as compared to about 6 days on the intensive-care unit. Extracentral effects were most prominent amongst the "sequelae" of intoxications. Discharged directly to their homes were 58%, 31% to psychiatric hospitals and 9% to general wards; 2% died. The primary elimination of poison was achieved by induced vomiting in 40% of the cases, and by pumping out the stomach in 23%. There were no serious clinical alterations of clinical test parameters. Artificial ventilation was required in 8%. 107 suicide cases (61%) investigated psychiatrically showed moderate (41%) and severe (20%) psychological abnormalities. Depressive syndrome (35%, of these 1 third with major depression), which frequently occurred in the context of an acute stress reaction, predominated amongst the diagnoses. Forty-two patients could be interviewed 6 days after suicide or parasuicide. Of those 90% interviewed had visited their family doctor in the course of the year before the current admission. Thirty-one patients had already received outpatient therapy and 15 had undergone an inpatient form of psychiatric therapy.