Clinical Characteristics of Pesticide Self-Harm as Associated with Suicide Attempt Repetition Status
Received 17 April 2020
Accepted for publication 28 June 2020
Published 16 July 2020 Volume 2020:16 Pages 1717—1726
Checked for plagiarism Yes
Review by Single anonymous peer review
Peer reviewer comments 2
Editor who approved publication: Dr Yuping Ning
Wei-Chen Huang,1 Tzung-Hai Yen,2,3 Long Lin,4 Chemin Lin,3,5,6 Yeong-Yuh Juang,7 Bi-Hwa Wang,8 Shwu-Hua Lee1,3
1Department of Psychiatry, Chang Gung Memorial Hospital, Linkou, Taiwan; 2Department of Nephrology and Clinical Poison Center, Chang Gung Memorial Hospital, Linkou, Taiwan; 3School of Medicine, College of Medicine, Chang Gung University, Taoyuan, Taiwan; 4School of Traditional Chinese Medicine, College of Medicine, Chang Gung University, Taoyuan, Taiwan; 5Department of Psychiatry, Chang Gung Memorial Hospital, Keelung, Taiwan; 6Community Medicine Research Center, Chang Gung Memorial Hospital, Keelung, Taiwan; 7Department of Psychiatry, Koo Foundation Sun Yat-Sen Cancer Center, Taipei, Taiwan; 8School of Nursing, College of Medicine, Chang Gung University, Taoyuan, Taiwan
Correspondence: Shwu-Hua Lee
Department of Psychiatry, Chang Gung Memorial Hospital, 5 Fu-Shin Road, Kwei-Shan, 333, Linkou, Taiwan
Tel +886 3 3281200 Ext 2439
Purpose: Previous suicide behavior predicts future suicide risk. Studies of suicide repetition are important for suicide prevention. This study examined the clinical characteristics and psychiatric comorbidities of pesticide self-harm as associated with suicide attempt repetition status.
Patients and Methods: This retrospective, observational study included patients admitted to a medical center in northern Taiwan between 2000 and 2015 following suicide attempts by pesticide. Diagnoses were made by a consultation-liaison psychiatry team based on the DSM IV-TR criteria. Independent samples t-test was used to analyze the quantitative variables and Pearson’s Chi-squared test with a Bonferroni adjustment for categorical variables. Univariate binary logistic regression analysis was conducted to determine the predictors for repeated suicide attempt and multivariate binary logistic regression analysis to identify significant associated factors.
Results: Among 151 patients, organophosphate pesticides were the most used (80.8%). The average age was 52.9± 17.2 years. Most patients were married males from rural areas, with depressive disorder most often diagnosed (40.4%). Nearly one-third of them were suicide repeaters (n=43, 28.5%); these patients were less likely to be married (53.5%, p=0.001), had previously used psychiatric services (72.1%, p< 0.001) and chose complex suicide (46.5%, p=0.014) more often compared to nonrepeaters. No significant differences were found between repeaters and nonrepeaters regarding psychiatric comorbidities. Multivariate logistic regression analysis revealed that marital status (odds ratio: 2.916, 95% confidence interval: 1.234– 6.891, p=0.015) and previous psychiatric services usage (odds ratio: 6.897, 95% confidence interval: 3.012– 15.625, p< 0.001) were significant risk factors associated with suicide repetition.
Conclusion: Pesticide suicide repeaters were characterized by less likely to be married and more likely to use psychiatric services before suicide attempts. These features help ensuring that the needs of people who have made a suicide attempt are addressed, and it reduces the likelihood of repetition.
Keywords: self-harm behavior, self-poisoning, intentional poisoning, organophosphate
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