ลักษณะผู้ป่วยพยายามฆ่าตัวตายที่มารับการรักษาที่โรงพยาบาลเชียงรายประชานุเคราะห์ ระหว่างปี พ.ศ.2555-2559

มาโนช หล่อตระกูล; Wimolrat Chaiprakarn; Rapeepan Kanjanakaroon; Waraporn Pongkaew

Authors

มาโนช หล่อตระกูล
Wimolrat Chaiprakarn Chiang Rai Prachanukroh Hospital, Thailand
Rapeepan Kanjanakaroon Chiang Rai Prachanukroh Hospital, Thailand
Waraporn Pongkaew Chiang Rai Prachanukroh hospital, Thailand

Keywords:

pesticides, adolescents, northern region

Abstract

Objectives Suicide attempts represent a crucial problem for public health services. The aim of this study was to determine the demographic and characteristics of patients with attempted suicide presenting to Chiang Rai Prachanukroh Hospital.

Methods A cross-sectional, retrospective study was conducted including all episodes of attempted suicide attending the emergency department of the hospital from January 2012 to December 2016. Data was collected from the hospital information system, patient medical records, self-harm surveillance registration forms, counselling record forms and death certificates.

Results A total of 1,376 suicide attempt presentations were made to the emergency department by 1,339 individuals. 619 cases were population from capital district (amphoe mueang) of Chiang Rai and 757 cases were referred from other hospitals. The mortality rate of study participants was 13.1%, with 116 death (64.4%) from paraquat ingestion. Analysis of cases within the capital district revealed the mean age of 30.6 ± 14.6 years and the largest numbers by age groups were 15-24 year-old (40.7%). The female-to-male ratio was 1.5:1. The most common method used in female was drug overdose (47.2%), mainly with paracetamol, whereas men were more commonly ingest agricultural chemicals (27%). Men had higher rates of hospital admission and mortality than women. 41.8% of those who attempted suicide did not have a diagnosable mental illness and 28.2% suffered from adjustment disorder. The most frequently reported reason for attempting suicide was family/interpersonal problems (76.5%).

Conclusions Suicide attempts were prevalent in adolescence aged 15-24 years. The findings suggest a link with impulsivity resulting from family and relationship problems. Positive coping skills, good social relationships and support should be promoted in these vulnerable individuals.

References

1. National Center for Suicide Prevention. Suicide rate per 100,000 population in 2017 [Internet]. 2018 [cited 4 October 2018]. Available from: https://www.suicidethai.com/report/download/files/2560_2018-07-13.zip.
2. Bertolote JM, Fleischmann A. A global perspective in the epidemiology of suicide. Suicidologi. 2002;7:6-8.
3. Diekstra RF, Gulbinat W. The epidemiology of suicidal behaviour: a review of three continents. World Health Stat Q. 1993;46:52-68.
4. Data Center of Chiang Rai Prachanukroh Hospital. 2017 Annual Report of Chiang Rai Prachanukroh Hospital [Internet]. 2017 [cited 6 October 2018]. Available from: https://www.crhospital.org/crhprofile/รายงานประจำปี/รายงานประจำปีงบประมาณ%202558.pdf.
5. Goodfellow B, Kolves K, de Leo D. Contemporary definitions of suicidal behavior: A systematic literature review. Suicide Life Threat Behav. 2018 Mar 24. doi: 10.1111/sltb.12457. [Epub ahead of print]
6. Mento C, Presti EL, Mucciardi M, Sinardi A, Liotta M, Settineri S. Serious suicide attempts: evidence on variables for manage and prevent this phenomenon. Community Ment Health J. 2016;52:582-8.
7. Fushimi M, Sugawara J, Saito S. Comparison of completed and attempted suicide in Akita, Japan.
Psychiatry Clin Neurosci. 2006;60:289-95.
8. Beautrais AL. Suicides and serious suicide attempts: two populations or one? Psychol Med. 2001;31:837-45.
9. Gunnell D, Eddleston M, Phillips MR, Konradsen F. The global distribution of fatal pesticide self-poisoning: systematic review. BMC Public Health. 2007;7:357.
10. Weissman MM, Bland RC, Canino GJ, Greenwald S, Hwu HG, Joyce PR, et al. Prevalence of suicide ideation and suicide attempts in nine countries. Psychol Med. 1999;29:9-17.
11. Thanh HT, Jiang GX, Van TN, Minh DP, Rosling H, Wasserman D. Attempted suicide in Hanoi, Vietnam. Soc Psychiatry Psychiatr Epidemiol. 2005;40:64-71.
12. Kawashima Y, Yonemoto N, Inagaki M, Yamada M. Prevalence of suicide attempters in emergency departments in Japan: a systematic review and meta-analysis. J Affect Disord. 2014;163:33-9.
13. Craig DG, Bates CM, Davidson JS, Martin KG, Hayes PC, Simpson KJ. Overdose pattern and outcome in paracetamol-induced acute severe hepatotoxicity. Br J Clin Pharmacol. 2011;71:273-82.
14. Page A, Liu S, Gunnell D, Astell-Burt T, Feng X, Wang L, et al. Suicide by pesticide poisoning remains a priority for suicide prevention in China: analysis of national mortality trends 2006-2013. J Affect Disord. 2017;208:418-23.
15. Chang SS, Lu TH, Sterne JA, Eddleston M, Lin JJ, Gunnell D. The impact of pesticide suicide on the geographic distribution of suicide in Taiwan: a spatial analysis. BMC Public Health. 2012;12:260.
16. Vijayakumar L. Challenges and opportunities in suicide prevention in South-East Asia. WHO South East Asia J Public Health. 2017;6:30-3.
17. Pearson M, Metcalfe C, Jayamanne S, Gunnell D, Weerasinghe M, Pieris R, et al. Effectiveness of household lockable pesticide storage to reduce pesticide self-poisoning in rural Asia: a community-based, cluster-randomised controlled trial. Lancet. 2017;390:1863-72.
18. Weerasinghe M, Konradsen F, Eddleston M, Pearson M, Jayamanne S, Gunnell D, et al. Vendor-based restrictions on pesticide sales to prevent pesticide self-poisoning - a pilot study. BMC Public Health. 2018;18:272.
19. Vongverapant M. The attempted suicide in Chiang Mai: A case study of Nakornping Hospital. [in Thai] Journal of Clinical Psychology. 2008;39:50-7.
20. Khamlue E. suicide attempters and completed suicide in Rongkwang hospital. [in Thai] Bulletin of SuanPrung. 2012;28:42-50.
21. Wang SY, Li YH, Chi GB, Xiao SY, Ozanne-Smith J, Stevenson M, et al. Injury-related fatalities in China: an under-recognised public-health problem. Lancet. 2008;372:1765-73.
22. Callanan VJ, Davis MS. Gender differences in suicide methods. Soc Psychiatry Psychiatr Epidemiol. 2012;47:857-69.
23. Cibis A, Mergl R, Bramesfeld A, Althaus D, Niklewski G, Schmidtke A, et al. Preference of lethal methods is not the only cause for higher suicide rates in males. J Affect Disord. 2012;136:9-16.
24. Mergl R, Koburger N, Heinrichs K, Szekely A, Toth MD, Coyne J, et al. What are reasons for the large gender differences in the lethality of suicidal acts? An epidemiological analysis in four European countries. PLoS One. 2015;10:e0129062.
25. Townsend E, Hawton K, Harriss L, Bale E, Bond A. Substances used in deliberate self-poisoning 1985-1997: trends and associations with age, gender, repetition and suicide intent. Soc Psychiatry Psychiatr Epidemiol. 2001;36: 228-34.
26. Lester D. Why do people choose particular methods for suicide? Act Nerv Super (Praha). 1988;30:312-4.
27. Zhang Y, Yu B, Wang N, Li T. Acute poisoning in Shenyang, China: a retrospective and descriptive study from 2012 to 2016. BMJ Open. 2018;8:e021881.
28. Mejias-Martin Y, Marti-Garcia C, Rodriguez-Mejias C, Valencia-Quintero JP, Garcia-Caro MP,
Luna JD. Suicide attempts in Spain according to prehospital healthcare emergency records. PLoS One. 2018;13:e0195370.
29. Varnik A, Sisask M, Varnik P, Wu J, Kolves K, Arensman E, et al. Drug suicide: a sex-equal cause of death in 16 European countries. BMC Public Health. 2011;11:61.
30. Oquendo MA, Mann JJ. The biology of impulsivity and suicidality. Psychiatr Clin North Am. 2000;23:11-25.
31. Zalsman G, Mann JJ. The neurobiology of suicide in adolescents. An emerging field of research. Int J Adolesc Med Health. 2005;17:195-6.
32. Chen YY, Wu KC, Yousuf S, Yip PS. Suicide in Asia: opportunities and challenges. Epidemiol Rev. 2012;34:129-44.
33. Lim M, Lee S, Park JI. Differences between impulsive and non-impulsive suicide attempts
among individuals treated in emergency rooms of South Korea. Psychiatry Investig. 2016;13:389-96.