Farmakolojik Ajanlarla Olan İntihar Girişimlerinin Değerlendirilmesi

Abstract

An Evaluation of Suicide Attempts with Pharmacologic Agents Suicide is defined as a voluntary desire of a person to put end to his own life and this is the most important cause of death in psychiatry. In this study we aimed to find causes of suicide attempts with pharmacologic agents. We reviewed the charts of Ure patients who were admitted to Ondokuz Mayis University Emergency Department due to intoxication with medications between the period of 01.01.2000-20.05.200. Previous history of a psychiatric disorder, number of suicide attempts, history of psychiatric disorder in the family, precipitating factors of suicide attempt, existance of psychiatric follow up or not and the sociodemographic data were recorded from the medical records of the 59 patient who met the criteria of suicide attempt with medication. The collected data were analyzed by SPSS statistical program. The ages of the patients were between 14-80 years (mean 25.57 years). Forty six of them were female (78%). Forty two of them were married, 42 of them were housewifes. The cause of suicide attempt were unknown in 32 patients (54%) but in 14 patients (23.7%) family problems were the main cause. Twenty seven patients were not seen in the Emergency Department (ED) by a psychiatrist (45.8%). The 17 patients who were seen by a psychiatrist were found to be normal in mental states examination. There were 2 patients who had physical disorder. The suicide attempts were realized with antidepressan in 12 patient (20.3%), with the other drugs in 12 patients with organophosphates in 10 patients (16.9%), 17 of them were seen by a psychiatrist the next day (28.8%), 23 of them were not evaluted by a psychiatrist. Only 4 patients were followed up by the psychiatry department after the event. As a result of this study we determined that the number of female and jobless persons who attempted suicide is high. Most frequently used agents were antidepressants. The patients attempted to suicide were discharged from ED without consultation of psychiatrist. And also a few patient who were consultated with psychiatrist did not follow-up by psychiatry department. As a conclusion the suicide attempts admitted to ED should be followed more seriously. Intihar girisiminde degisik faktorler rol oynamaktadir. Bu nedenle biz bu retrospektif arastirma ile intihar girisimine sebep olan faktorleri belirlemeyi, intihar girisiminde kullanilan farmakolojik ajanlarin hangileri oldugunu saptamayi amacladik. Bu amacla Ondokuz Mayis Universitesi. Tip Falcultesi acii servisine 01.01.2000 - 20.05.2000 tarihleri arasinda ilac intoksikasyonu nedeniyle basvuran hasta dosyalarim geriye donuk olarak inceledik. Verilerine ulasilan 59 kisinin: aldigi ilac tipi, daha once psikiyatrik tanisi olup olmadigi, kacinci intihar girisimi odugu, ailede ruhsal hastalik olup olmadigi, psikiyatri bolumunce hastanin takibe alinip alinmadigi ve intihar girisiminde bulunmasina etken olan stressorlerin ne oldugu ile sosyodemografik veriler kayit edildi. Hastalanil 46'sinin kadin, 42'sinin evli, 42'sinin ev hanimi oldugu saptandi. Hastalann 32'sinde (%54.2) intihal etkeni belli degil iken, 14'unde (%23.7) aile sorunlari neden olarak belirtildi. 27 hasta (%45.8) acil serviste psikiyatri bolumunce gorulmemis olup, gorulen 17 kisiye de (%28.8) normal ruhsal muayenesi oldugu belirtilmisti. Hastalann 12'si (%20.3) antidepresanlar ile 10'u (%16.9) organik fosfor alimi ile intihar girisiminde bulunmuslardi. Hastalarin 17'si (%28.8) bir gun sonra psikiyatri bolumunce gorulmus, 23'u (%39) hic gorulmemis idi. Sadece 4 hastanin da daha sonra psikiyatri bolumunce takibe alindigi saptandi. Sonucta kadin ve issiz olanlarda intihar girisiminin daha fazla oldugu belirlendi. Intihar girisimlerinde en sik kullanilan ajanlann antidepresanlar oldugu goruldu. Ayrica bu calismada, gerek cogu hastanin acil serviste psikiyatri bolumunce gorulmeden taburcu edilmesi, gerekse hastalarin daha sonra psikiyatri bolumu tarafindan hic kontrol edilmemis olmasi goz onune alindiginda intihar vakalarina daha fazla onem verilmesi gerektigi kanisina varildi.