Is a Psychiatric Consultation Necessary for the Non-Suicidal Intentional Drug Ingestion Patient in an Emergency Department?

Min, Hyeon Gyu; Choi, Han Sung; Kwon, Oh Young; Lee, Jong Seok; Hong, Hoon Pyo; Ko, Young Gwan; Paik, Jong Woo; Kim, Sin Chul; Kim, Dong Pil

Abstract

PURPOSE
The purpose of this study was to investigate the relationship between suicide risk factors and psychiatric disorders, and between suicide risk factors and suicide attempts after discharge, and to analyze the necessity of a psychiatrist referral in patients who intentionally ingested drug but did not make a suicide attempt.
METHODS
Between January 1, 2004 and December 31, 2008, we investigated cases of intentional drug ingestion in patients greater than 15 years of age who visited Kyung Hee University emergency medical center. We divided the patients into two groups - a suicide attempt group and a non-suicide attempt group. The difference between suicide risk factors of the two groups was investigated prospectively. Among the risk factors for suicide, we determined whether psychiatric diagnosis was highly associated with suicide and whether it was an influential factor in suicide attempts after discharge. SPSS version 13.0 was used for statistical analysis. Chi-square, paired sample t-test, and Fisher's exact test were performed, and a p<0.05 was considered to be statistically significant.
RESULTS
There were no significant differences in suicide risk factors between the two groups (p>0.05). Patients who did not attempt suicide who had a psychiatric history associated with suicide attempts, who had previous suicide attempts, who had a family history of suicide, and who lived alone, may have psychiatric disorders associated with suicide or suicide attempt after discharge (p<0.05).
CONCLUSION
All patients who intentionally ingested drugs should be given a psychiatrist referral, even if the patients did not attempt suicide. In particular, the psychiatric referral should be made when the patient has risk factors such as a psychiatric history associated with suicide attempts, previous suicide attempts, a family history of suicide, and living alone.