Repeated self-poisoning: an addictive rather than a suicidal behaviour?

Abstract : Background: Self-poisoning (SP) is the leading self-harm method. Mechanisms of SP repetition (SP-r) are poorly understood and questions remain regarding its prevention. Methods: A chart review was undertaken in 2012 in a French university hospital to identify risk factors for an admission for a first, a second, or a third and more SP. Readmission rates and costs were assessed. Results: 730 SPs for 635 patients were analysed and 418 (57%) SPs corresponded to a repetition. A cutting self-harm history, a specialised or an interrupted mental follow-up were associated to the SP-r. Multiple repeaters were more likely to be unemployed, suffering from personality disorders, tobacco use and alcohol misuse, ingesting benzodiazepines for the SP, and being readmitted for a SP within one year (9%, 15%, and 30% for first, second and third and more SPs respectively). The suicidal ideation (49%) or premeditation (10%) were similar between the groups. SP-r contributed 54% (EUR 902 k) of the hospital costs related to SPs in 2012. Conclusion: The vulnerability to tobacco use/alcohol misuse, the use of benzodiazepines for the SP-r, the associated binge-drinking, the SP chronicity, the absence of suicidal ideation in 51% of SPs, and the great prevalence of impulsivity (10% of premeditated SPs) in multiple repeaters are consistent with the hypothesis of a psychotropic prescription drugs misuse, leading to SP-r. Repeated SPs presented characteristics of binge-drugging and benzodiazepines consumption (repetition, abuse, impulsive-compulsive-automatic) should be examined systematically to address these patients to adapted care.
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Asma Fares. Repeated self-poisoning: an addictive rather than a suicidal behaviour?. Human health and pathology. 2017. ⟨dumas-02138763⟩

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