Lower rates of hospital presentation for self-poisoning during COVID-19

Dr Margaret Shi
07 Sep 2021

A recent cohort study showed almost a one-third reduction in hospital presentations for self-poisoning in Sri Lanka immediately following the start of the coronavirus disease 2019 (COVID-19) lockdown.

“The reduction in number of hospital presentations for self-poisoning during the COVID-19 lockdown appeared to be due to a reduction in number of medication overdose, attributed to increased social integration during times of community-wide disasters in Sri Lanka,” suggested the authors. [Lancet Psychiatry 2021:S2215-0366(21)00242-X]

“Nonetheless, caution is required as some individuals who have self-harmed may feel reluctant to present to hospitals because of fears over potential severe acute respiratory syndrome coronavirus 2 infection. Future studies are required to assess the impact of COVID-19 towards hospital presentation for self-poisoning. The message of seeking medical attention early should be emphasized by public health experts and clinicians,” the authors added.

In the interrupted time-series analysis, data of 1,401 individuals (female, 54.3 percent) admitted to the Toxicology Unit for treatment of self-poisoning between 1 January 2019 and 31 August 2020 were extracted from a newly established self-poisoning register at the tertiary care Teaching Hospital Peradeniya in Sri Lanka.

Overall, analgesic overdose accounted for the majority (57.9 percent) of medication overdose throughout the study period.

A 32 percent significant reduction in hospital presentations for self-poisoning was observed during the pandemic period compared with the pre-pandemic period (rate ratio, 0.68; 95 percent confidence interval [Cl], 0.52 to 0.88), with the reduction being independent of a steady long-term decline in number of presentations following self-poisoning.

The impact of COIVD-19 on the number of hospital presentations for self-poisoning did not differ by sex (rate ratio 0.64; 95 percent CI, 0.44 to 0.94, for females vs 0.85; 0.57 to 1.26; for males; pinteraction=0.43) or age (rate ratio, 0.64; 0.44 to 0.93, for patients aged <25 years vs 0.81, 0.57 to 1.16, for patients aged ≥25 years; pinteraction=0.077).

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