Suicidally motivated intoxication by psychoactive drugs: characterization among the elderly

Abstract Objective: to characterize suicidally motivated intoxication by psychoactive drugs among elderly people. Method: a retrospective and documentary study with a quantitative approach was carried out, based on the notification forms of 692 cases of suicidally motivated intoxications by psychoactive drugs, registered by the Centro de Assistência Toxicológica (the Toxicological Care Center) in Fortaleza, Ceará, Brazil from 2010 to 2014. The absolute and relative frequencies of social conditions, intoxication episodes and clinical conducts were obtained, and the Chi-squared Test was applied with a significance of p≤0.05. Results: elderly people aged between 60 and 69 years (65.9%), who were female and retired predominated. The most frequently used psychoactive drugs were antidepressants (48.3%) and anxiolytics/hypnotics (29.0%). The most frequent clinical conducts were the use of activated charcoal and gastric lavage. Moderate poisoning was the most frequent, and the main outcome was discharge arising from cure. There was a significant relationship between the elderly persons and gender, occupation, occurrence of intoxication at home, clinical manifestation and hospital admission. Conclusion: suicidally motivated poisoning by psychoactive drugs in elderly persons suggests the need to promote active aging, as well as the access to and rational use of these drugs, thereby reducing harm and preserving the lives of elderly persons.

摘要 研究目的：本研究旨在阐明老年人群因精神活性药物（psychoactive drugs）引发自杀性中毒的临床特征。
方法：本研究采用回顾性文献研究结合定量分析方法，以巴西塞阿拉州福塔莱萨市毒理救治中心（Centro de Assistência Toxicológica，Toxicological Care Center）2010—2014年登记在册的692例精神活性药物自杀性中毒病例的上报表单为基础开展研究。研究获取了社会境况、中毒事件及临床处置方式的绝对频数与相对频数，并采用卡方检验（Chi-squared Test）进行统计学分析，检验水准设定为p≤0.05。
结果：研究对象以60~69岁老年女性退休群体为主，占比达65.9%。最常使用的精神活性药物为抗抑郁药（48.3%）与抗焦虑药/催眠药（29.0%）。最常见的临床处置方式为活性炭吸附与洗胃。中度中毒为最主要的中毒程度类型，主要预后结局为临床治愈后出院。老年人群的性别、职业、中毒发生场所、临床表现与住院收治情况之间存在显著统计学关联。
结论：老年人群因精神活性药物引发的自杀性中毒问题提示，需推动积极老龄化进程，同时加强此类药物的可及性管理与合理使用，以降低老年人群中毒风险、守护其生命健康。