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Journal of The Korean Society of Emergency Medicine 2005;16(1): 158-163. |
| Psychiatric Follow-up after ED Discharge in Cases of Intentional Poisoning |
| Jin Kyung Cho, In Cheol Park, Yoo Sang Yoon, Seung Ho Kim, Kyeong Ryong Lee |
1Department of Emergency Medicine, Yonsei University College of Medicine, Seoul, Korea. edksh@yumc.yonsei.ac.kr
2Department of Emergency Medicine, Konkuk University College of Medicine, Seoul, Korea. |
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| ABSTRACT |
PURPOSE:
Many patients who intentionally poison themselves are reported to have underlying mental problems and to repeat the attempted suicidal poisoning. As a first step to prevent this regretful complication, we looked into the present status of psychiatric follow-up of the patients who intentionally poisoned themselves.
METHODS:
Using a chart review and telephone contact, we analyzed the psychiatric follow-up rate, the underlying psychiatric illness, the number of suicidal attempts, and the reasons for no follow-up for adult patients who intentionally poisoned themselves and who visited the Emergency Department of Severance Hospital from Mar. 2003 to Feb. 2004 with chart review, telephone contact.
RESULTS:
Forty-nine of 119 suicide patients (41.2%) chose poisoning as a means of suicide. The results of emergency treatment of those 119 patients were 4 deaths during treatment, 36 admissions (15 psychiatry, 21 others), and 79 discharges including 5 transfers. The most common underlying psychiatric problem based on 103 initial psychiatric interviews was depressive disorder in 52(50.5%) patients.
Not counting the 19 deaths and psychiatry admissions, 26 patients received psychiatric follow-up during admission or after discharge, and the remaining 74 patients were subjected to telephone surveys. In the telephone surveys, only 53 patients were contacted; 25 patients declined to answer the questions and out of the 28 patients who answered them, 5 patients had received psychiatric follow-up at other hospitals. The most common reason given by the other 23 patients for no follow-up was that it was not necessary (39.1%, 9/23). The overall follow-up rate was 39.2% (31/79).
Of the 48 patients who answered the question on repeated suicide attempts, 3 patients had repeatedly attempted suicide.
CONCLUSION:
To prevent further suicide attempts and resultant deaths in cases of patients who intentionally poisoned themselves, we urgently need an integrated psychiatric follow- up care program that is activated through a collaborative effort before discharge from the emergency department. |
| Key words:
Intention, Poisoning, Psychiatry |
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