Characteristics and psychopathology of 1,086 patients who self-poisoned using pesticides in Taiwan (2012–2019): A comparison across pesticide groups

• Published in: Journal of affective disorders 2022-03, Vol.300, p.17-26
• Main Authors: Tu, Chao-Ying, Yen, Tzung-Hai, Chang, Chia-Ming, Chen, Hsien-Yi, Yen, Yung-Chieh, Guo, Ming-Chao, Lu, Tsung-Hua, Wu, Chi-Shin, Chen, I-Ming, Cheng, Hai-Ching, Huang, Wei-Lieh, Chen, Cheng-Che, Eddleston, Michael, Chang, Shu-Sen
• Format: Article
• Language: English
• Subjects: Aged; Humans; Male; Mental Disorders - epidemiology; Paraquat; Pesticides; Poisons; Psychopathology; Retrospective Studies; Self-poisoning; Suicide prevention; Taiwan; Taiwan - epidemiology
• ISSN: 0165-0327; 1573-2517
• DOI: 10.1016/j.jad.2021.12.058

•Past research suggested that many pesticide self-poisonings were impulsive with low levels of psychopathology.•Three quarters of pesticide self-poisoning patients who received psychiatric assessment in Taiwan had psychiatric illness.•The psychopathology of patients who ingested different groups of pesticides was similar.•Psychiatric assessment and treatment are important in managing pesticide self-poisonings.•Restricting highly hazardous pesticides would be effective in reducing many pesticide self-poisoning deaths. Background Previous studies, mainly from low- and middle-income settings, showed that pesticide self-poisonings were mostly impulsive with low levels of psychopathology. We aimed to investigate whether pesticide self-poisoning in a high-income country showed similar profiles, and whether those with certain characteristics and psychopathology were more likely to use specific pesticides. Methods Data were extracted from hospital records of pesticide self-poisoning patients treated at eight major hospitals in Taiwan between 2012 and 2019. Multinomial logistic regression was used to investigate the association of interpersonal conflicts, triggers of self-poisoning, and psychopathology with the groups of pesticides ingested. Results A total of 1,086 patients who self-poisoned using pesticides were identified; 67.0% were male and 39.8% aged 65+ years. Approximately three quarters (75.7%) of patients who received psychiatric assessment had at least one psychiatric diagnosis, and the prevalence was 48.3% in all patients. No association was found between the pesticide groups ingested and interpersonal conflicts, most of the triggers, past psychiatric service use, or having psychiatric diagnoses. Limitations Data were collected from hospital records retrospectively. Only 60.3% of the patients received a psychiatric assessment. Conclusions The majority of patients who self-poisoned using pesticides and received psychiatric assessment in Taiwan had psychiatric illness. Patients who ingested different groups of pesticides were similar in their characteristics. The choice of pesticides used in self-poisoning more likely relates to availability rather than intentional selection. Psychiatric assessment and treatment are important in patients who self-poisoned using pesticides, while restricting access to highly hazardous pesticides is likely to prevent many deaths from pesticide self-poisoning.