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J Korean Soc Emerg Med > Volume 16(1); 2005 > Article
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.
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.
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.
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.
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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