Patient Behaviour on Non-Accidental Poisoning - A Prospective Study

Abstract

Poisoning or drug overdose is a common presentation to the Accident and Emergency Departments (AED) in Hong Kong. This prospective study examined 74 patients with intentional poisoning attending an Accident and Emergency department over a 3 month-period. A pre-set questionnaire was designed seeking the following information: demographic characteristics, patient behaviour, the source of ingestants, patient's knowledge about the ingestants, home interventions, medical and psychiatric history, and final outcomes. The incidence of intentional poisoning was 0.16%. Most were female in 21–40 years age group, single, had a job and had secondary level education. They were usually healthy and had no psychiatric illness. Drugs (mostly hypnotic/sedatives) and household products made up most of the ingestants. The ‘Sleep-On’, ‘Sleep-Qik’, and ‘Honslin' were the most common hypnotic/sedative. These ingestants were chosen largely because of their easy accessibility rather than the toxicity. The majority presented within 2 hours of ingestion although with an initial attempt to die, paradoxically they did not believe that they would die from the overdose. Most events occurred at patient's own home. Emotional, family and marital problems constituted the vast majority of the precipitating factors. About 40% of patients ingested more than one substance (alcohol being the most common co-ingestant) or had an concurrent acting-out behaviour. Although most patients knew the nature of the ingestant, very few (less than 15%) understood its side-effects or their contraindications. There was no mortality or significant morbidity. Over 60% did not have any psychiatric disorder after psychiatric assessment. Knowledge of pattern of poisonings and patient behaviour in local setting is important in terms of prevention, public education and the provision of the optimal care to these patients.