Deliberate medication poisoning in adolescence as a medical and socially significant problem

Abstract

One of the urgent medical and social problems of modern society is the steady growth of auto-aggressive behavior and deliberate medication poisoning among adolescents and young adults. This investigation was held to optimize the provision of specialized medical care for acute deliberate self-poisoning in teenagers. We examined 498 patients admitted to the Toxicology Department of N. F. Filatov Children City Clinical Hospital No. 13 with a diagnosis of acute deliberate medication poisoning. The diagnosis was confirmed by chemical and toxicological urine test using thin-layer chromatography. From 2016 to 2018 the number of patients with deliberate medication poisoning increased by more than 2.5 times and amounted to 236 cases. Female patients were prevalent and accounted for up to 85% of cases. The leading position among medication self-poisoning is held by psychopharmacological drugs at 56%, in second place are non-steroidal anti-inflammatory drugs at 18.5%. The main causes of self-poisoning were social or family conflicts (47%), problems at school (35%), and Internet-related complaints (18%). The clinical manifestations of the disease in the acute period of chemical poisoning depended on the toxic agent and the dose taken. Psychological testing revealed a high level of neuroticism in 71% of adolescents, severe anxiety was observed in 57% of patients, and depression was diagnosed in 28% of cases. All patients were provided specialized medical care, including resuscitation, detoxification, and psychiatrist examination. Based on the accumulated clinical experience, an algorithm for managing adolescents with deliberate medication poisoning has been developed, which has reduced the number of repeated suicides by 1.8 times.