Sociodemographic and Clinical Profile of Poisoning Cases in a Tertiary Care Hospital: A Retrospective Study With Psychiatric Correlates

三级医院中毒病例的社会人口学和临床特征:一项回顾性研究及其与精神病学的相关性

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Abstract

Background and objective Poisoning remains a significant public health concern in underdeveloped countries, particularly among young adults. Intentional poisoning is increasingly recognized as a manifestation of psychological distress and difficulty coping with daily stressors; however, data on the psychiatric aspects of poisoning are limited. This study aimed primarily to identify psychiatric comorbidities and psychosocial stressors associated with poisoning. Secondary objectives included describing the sociodemographic characteristics, clinical profile, types of poisoning, and clinical outcomes of affected patients admitted to a tertiary care hospital. Methodology This retrospective study was conducted at a tertiary care hospital in Chennai. Medical records of patients admitted with poisoning between January 2018 and January 2023 were reviewed. Of 381 records retrieved, 36 were excluded due to incomplete data, resulting in a final sample of 345 patients. Adults aged ≥18 years with a diagnosis of poisoning based on the ICD-10 coding were included. Exclusion criteria were age <18 years, pregnancy, food poisoning, animal bites, chronic toxicity, and patients declared dead on arrival. Data on sociodemographic variables, type of poisoning, psychosocial stressors, psychiatric diagnoses, and clinical outcomes were extracted from electronic medical records. Psychiatric diagnoses were obtained from consultation-liaison psychiatry notes documented during hospitalization and made by qualified psychiatrists using ICD-10 criteria following clinical assessment. Data were collected using a structured abstraction tool and analyzed using IBM SPSS Statistics for Windows, Version 22.0 (Released 2013; IBM Corp., Armonk, NY, USA). Normality was assessed using the Shapiro-Wilk test. Independent sample t-tests and chi-square tests were used for continuous and categorical variables, respectively, and Pearson's correlation was applied to assess associations between psychiatric diagnoses and selected clinical variables. Results Most patients were aged 18-30 years (47.8%, n = 165), female (70.1%, n = 242), married (71.3%, n = 246), and from socioeconomic class II (53%, n = 183). The most common poisoning agents were corrosives (22.9%, n = 79) and benzodiazepines (19.1%, n = 66). Poisoning was planned in 95.9% (n = 331) of cases and occurred at home in 96.5% (n = 333). Psychiatric morbidity was identified in 42.6% (n =147) of patients, most commonly mood disorders (25.2%, n = 88), with depressive disorder accounting for 21.7%. Adjustment and stress-related disorders (3.8%) and personality disorders (3.8%) were also noted. Age group (p = 0.002) and presence of psychosocial stressors (p = 0.041) showed significant associations with psychiatric diagnoses. Conclusion Intentional poisoning was more frequently observed among young women, often in the context of interpersonal, familial, and marital stressors. A substantial proportion of patients had underlying psychiatric morbidity, predominantly mood disorders. These findings underscore the importance of integrated psychiatric evaluation and early psychosocial intervention in the management and prevention of poisoning, particularly among vulnerable populations.

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