A Cohort Study of Patterns and Predictors of Repeated Self-Poisonings in NSW, Australia. — The Association Specialists
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  3. A Cohort Study of Patterns and Predictors of Repeated Self-Poisonings in NSW, Australia.

A Cohort Study of Patterns and Predictors of Repeated Self-Poisonings in NSW, Australia. (23812)

Christy Mo 1 , Rose Cairns 2 3 , Nicholas Buckley 2 3 , Jacques Raubenheimer 2
  1. School of Medical Sciences, The University of Sydney, Sydney, NSW, Australia
  2. Sydney Pharmacy School, The University of Sydney, Sydney, NSW, Australia
  3. Poisons Information Centre, The Sydney Children’s Hospitals Network, Westmead, NSW, Australia

Background: Intentional self-poisoning is a prevalent method of self-harm and suicide worldwide. While considerable research has focused on single poisoning events, studies utilising a data linkage to examine repeated self-poisonings remain limited. Previous studies have established that recurrent episodes of self-poisoning are common and strongly predict subsequent suicide and premature death. Identifying factors contributing to the increased risk of repetition and understanding patterns of recurrence is crucial for effective prevention.

Methods: We conducted a retrospective cohort analysis using the Poisoning and envenomation linkage to evaluate outcomes and clinical variation in Australia (PAVLOVA) data linkage, capturing self-poisoning admissions and readmissions across all NSW hospitals from 2011 to 2020 using ICD-10-AM diagnostic codes. Key data extracted include patient demographics, clinical characteristics, and the substances involved in each self-poisoning event.

Results: A total of 49,259 patients had an index non-fatal intentional self-poisoning admission during the data collection period. A total of 9,692 (19.7%) patients went on to have two or more repeat self-poisoning events. Factors significantly associated with an increased risk of repeat include female sex, aged 30–39, unmarried, and patients with psychiatric comorbidities. Certain substances used at the index event were predictive of repeat, particularly pharmaceuticals such as endocrine drugs, benzodiazepines, and antipsychotics. The use of multiple substances, particularly paracetamol co-ingestion, was associated with an increased risk of repeat. Patients who repeated self-poisoning frequently transitioned to using multiple substances, and more often switched to a different substance in subsequent events rather than continuing with the same one.

Conclusion: These findings provide evidence for targeted prevention strategies to improve patient outcomes and inform policy making decisions aimed at reducing the risk of repeated self-poisonings.