Pattern of self-poisoning and toxicity in suicidal deaths presenting for autopsy at the teaching hospital of the cosmopolitan city of Pakistan

Abstract

Background and objective: Suicide is a common cause of death among teenagers and young adults and day by day, an increase has been observed in this trend. In most cases, home-based materials are used for this purpose. Hence, we aim to determine the frequency of various poisonous agents used for suicide and the pattern of presentation of such suicidal death for autopsies at a teaching hospital in a cosmopolitan city of Pakistan.
 Methods: This Cross-sectional study was conducted at the Toxicology and Forensic Medicine Department, Allama Iqbal Medical College, Lahore over a 1-year period from 1-4-2022 to 1-4-2023. About 60 dead bodies of deceased committing suicide were included through non probability consecutive sampling. Poisonous material used for suicide was inquired from family or next of kin and was verified with a toxicology report. Data was then recorded in proforma and analyzed in SPSS version 25.
 Results: The mean age of dead bodies at the time of death was 29.51 ± 14.92 years. There were 37 (61.7%) male bodies and 23 (38.3%) female bodies. The mean duration between death and body received for autopsy was 2.4 ± 1.7 days. Out of 60 cases, 37 (61.7%) cases had a history of depression before suicide, 6 (10.0%) were taking anti-psychiatric treatment, 2 (3.3%) had schizophrenia, 4 (6.7%) had depressive disorder, while 11 (18.3%) had no depressive symptoms or relatives were unaware of that. Out of 60 cases; 12 (20.0%) committed suicide with organophosphates, 10 (16.7%) took over-the-counter drugs, 8 (13.3%) ingested household chemicals or acid, 6 (10.0%) took kala pather, 6 (10.0%) ingested wheat pills, 5 (8.3%) took cocaine in overdose, 5 (8.3%) had methamphetamines overdose, 3 (5.0%) had cannabinoids, 2 (3.3%) had methadone, 2 (3.3%) benzodiazepines and 1 (1.7%) had alcohol overdose.
 Conclusion: Organophosphate (pesticide) is the most commonly used suicidal poisoning agent, followed-by household acids in cosmopolitan cities (urban areas). Stringent regulations are needed to regulate the sale of these toxic materials to avoid unnatural deaths of our youth.