Voluntary pharmacological drug poisoning in 267 adolescents
Keywords:
drug poisoning, adolescent, depressive disorderAbstract
Background and aim: Adolescence, a period of biopsychosocial change, is particularly vulnerable to unsafe behaviors such as voluntary drug poisoning (VDP). The main objective of this study was to characterize the epidemiology, clinical characteristics and management of admissions due to VDP in a Pediatric Emergency Department in Lisbon.
Methods: Retrospective study between january 2015 and december 2022 by reviewing computerized inpatient records of all admissions of children up to 18 years old due to VDP.
Results: During the study period, a total of 267 admissions were identified, with a predominance of female gender and a median age of 16 years. Regarding personal history, 83.1% of adolescents had a psychiatric disorder, and 74.8% of these individuals were receiving medication. Approximately 39% had experienced at least one previous episode of VDP. Half of the patients were symptomatic upon admission, with neurological manifestations being the most common. Among the medications involved, acetaminophen was the most frequently identified (23.6%), and within the pharmacological classes, antipsychotics were the most commonly used, followed by benzodiazepines and antidepressants. Interventions in the Emergency Department included activated charcoal, gastric lavage and specific antidotes targeted at the ingested toxin. The primary precipitating factors were family conflicts, conflicts with a partner and bullying.
Conclusions: There is a significant association between VDP and psychiatric disorders. The high prevalence of medication use among these patients emphasizes the need for close monitoring of those undergoing pharmacological treatment. The identified triggering circumstances underscore the critical role of psychosocial factors, highlighting the importance of targeted interventions.
References
1. Nistor N, Jitareanu C, Frasinariu OE, Ciomaga IM, Rugina AL, Streanga V. Epidemiologic profile and triggering factors of voluntary poisoning in teenagers. Medicine 2017;96:5e5831. doi: 10.1097/MD.0000000000005831.
2. Sawyer SM, Azzopardi PS, Wickremarathne D, Patton GC. The age of adolescence. Lancet Child Adolesc Health 2018;2:223-228. doi: 10.1016/S2352-4642(18)30022-1
3. Auerbach RP, Stewar JG, Johnson S. Impulsivity and Suicidality in Adolescent Inpatients. J Abnorm Child Psychol 2017;45(1):91-103. doi: 10.1007/s10802-016-0146-8.
4. Almeida S, Antunes JJ, Barros M, Pinheiro A. Intoxicações Agudas em Pediatria. Lusiadas Sci J 2022;3:8-14.
5. Pawer S, Rajabali F, Zheng A, Smith J, Purssell R, Pike I. Analyses of Child and Youth Self-Poisoning Hospitalizations by Substance and Socioeconomic Status. Int J Environ Res Public Health 2021;18:7003. doi: 10.3390/ijerph18137003.
6. Roversi M, Martini M, Musolino A, Pisani M, Zampini G, Genuini L et al. Drug self-poisoning in adolescents: A report of 267 cases. Toxicol Rep 2023;10:680-685. doi: 10.1016/j.toxrep.2023.05.012.
7. Cairns R, Karanges EA, Wong A, Brown JA, Robinson J, Pearson SA. Trends in self-poisoning and psychotropic drug use in people aged 5-19 years: a population-based retrospective cohort study in Australia. BMJ Open 2019;9:e026001. doi: 10.1136/bmjopen-2018-026001.
8. Sheridan DC, Hendrickson RG, Lin AL, Fu R, Horowitz BZ. Adolescent Suicidal Ingestion: National Trends Over a Decade. J Adolesc Health 2017;60:191-195. doi: 10.1016/j.jadohealth.2016.09.012.
9. Farah R, Rege SV, Cole RJ, Holstege CP. Suspected Suicide Attempts by Self-Poisoning Among Persons Aged 10-19 years During the COVID-19 Pandemic – United States, 2020-2022. MMWR 2023;72:426-430. doi: 10.15585/mmwr.mm7216a3.
10. Predescu E, Calugar I, Monus CB, Sipos R. Trends and prevalence of hospital admissions related to deliberate self-poisoning and used substances in Romanian adolescents between 2016 and 2022. Children 2023;10:790. doi: 10.3390/children10050790.
Downloads
Published
Issue
Section
License
Copyright (c) 2025 Joana Lage, Filipa Paixão, Teresa Faria, Helena Isabel Almeida
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Transfer of Copyright and Permission to Reproduce Parts of Published Papers.
Authors retain the copyright for their published work. No formal permission will be required to reproduce parts (tables or illustrations) of published papers, provided the source is quoted appropriately and reproduction has no commercial intent. Reproductions with commercial intent will require written permission and payment of royalties.
How to Cite
