Interaction Effects between Intentional Poison, Suicide Attempts, Psychological Disorders, and Gender Using Log-linear Models Approach

Abstract

Background: Based on research evidence, intentional poisoning has a relatively high prevalence among people with psychiatric disorders, and the diagnosis of psychological disorders can be an important predictor of suicide attempts and their recurrence. Gender presents a determinant in the occurrence of psychiatric conditions and suicidal behaviors. Objective: This study aimed to investigate the relationship between suicide attempts, psychiatric disorders, and gender in individuals hospitalized due to intentional poisoning. Methods: This study used the data obtained from the disease registration program based on the data of the patients hospitalized due to intentional poisoning during a two-year followup (2021-2022), including a total of 658 patients. In this study, log-linear models were used to assess the relationships between the main variables that independently entered the model. The outputs of the log-linear model we reanalyzed as independent, two-way, threeway, and saturated models using relevant fit indices. Finally, the results of the best model were presented. Results: Based on the conditional values retrieved from the final model, the risk of intentional poisoning was lower in women than in men after adjusting for the variables of a history of suicide attempts and the results of psychological assessment (OR=0.25, 95% CI: 0.16-0.37, p = < 0.001). The risk of suicide attempts in women suffering from underlying psychiatric disorders (OR=1.57, 95% CI: 0.81-2.99, p = 0.188) and in women without underlying psychiatric disease, which was not statistically significant (OR=1.07, 95% CI: 0.47-2.69, p = 0.785). Also, the results showed that the risk of psychiatric disorders in people who had a prior suicide attempt (OR= 1.88, 95% CI: 1.05-2.25, p = < 0.001) and in women (OR=1.92, 95% CI: 1.05-2.77, p = < 0.001) was statistically significant. Conclusion: Based on our findings, men suffering from underlying psychological disorders and prior suicide attempts had a higher risk for intentional poisoning. On the other hand, among people without a history of suicide attempts and without underlying psychological disorders, the risk of intentional poisoning was higher in women. Moreover, a positive history of suicide attempts in both genders significantly increases the risk of having a psychological disorder. Therefore, it seems that underlying psychological disorders and a positive history of suicide attempts render women more vulnerable to intentional poisoning than men. Overall, it is suggested to consider screening for psychological disorders as a preventive measure in individuals proven to have intentional poisoning and suicide attempts, especially in men.