Self-poisoning as a cause of admission in a medical intensive care unit and a question of misuse of prescription medications

Background: Self-poisoning accounts for between 3 and 17% of intensive care unit (ICU) admissions. Objectives: To display the misused substances, intention, and outcome of patients admitted to the ICU due to self-poisoning. Methods: A retrospective review of ICU admissions using an electronic patient database was performed. Results: A total of 149 patients were admitted, accounting for 4.6% of ICU admissions. Self-poisoning with self-harm was more frequent than without self-harm intent (62.4% vs. 37.6%). 64.4% of ingested substances were misused prescribed drugs. Females used antipsychotics (X-2 = 15, p< 0.05) and benzodiazepines (X-2 =11.52, p< 0.05), and males ingested antipsychotics (X-2 = 12, p< 0.05) with a self-harm intent. Antipsychotics were always used with a self-harm intent. Illicit drugs (X-2 =9.14, p< 0.05) and ethanol (X-2 =7.34, p< 0.05) were mostly used without self-harm intent. 102 patients (68.5%) continued treatment in a psychiatric clinic, more often women (X-2 (1,N = 145)=7.94, p< 0.005). The readmission rate was low. Mortality was 2.6%. Conclusion: Self-poisoning is an infrequent cause of ICU admission. Prescribed psychotropic medications, including benzodiazepines, antipsychotics, and antidepressants were the most frequently misused substances. Psychiatric consultation before the ICU discharge and subsequent psychiatric treatment might lower the repetition and readmission rate. (C) 2021 Elsevier Inc. All rights reserved.