Hostname: page-component-cd9895bd7-hc48f Total loading time: 0 Render date: 2024-12-27T02:56:00.290Z Has data issue: false hasContentIssue false

Psychiatric intervention and repeated admission to emergency centres due to drug overdose

Published online by Cambridge University Press:  02 January 2018

Akiko Kanehara*
Affiliation:
Department of Youth Mental Health, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
Hayato Yamana
Affiliation:
Department of Clinical Epidemiology and Health Economics, School of Public Health, The University of Tokyo, Tokyo, Japan
Hideo Yasunaga
Affiliation:
Department of Clinical Epidemiology and Health Economics, School of Public Health, The University of Tokyo, Tokyo, Japan
Hiroki Matsui
Affiliation:
Department of Clinical Epidemiology and Health Economics, School of Public Health, The University of Tokyo, Tokyo, Japan
Shuntaro Ando
Affiliation:
Department of Health Policy and Informatics, Tokyo Medical and Dental University Graduate School of Medicine, Tokyo, Japan
Tsuyoshi Okamura
Affiliation:
Department of Neuropsychiatry, The University of Tokyo Hospital, Tokyo, Japan
Yousuke Kumakura
Affiliation:
Department of Neuropsychiatry, The University of Tokyo Hospital, Tokyo, Japan
Kiyohide Fushimi
Affiliation:
Department of Health Policy and Informatics, Tokyo Medical and Dental University Graduate School of Medicine, Tokyo, Japan
Kiyoto Kasai
Affiliation:
Department of Neuropsychiatry, The University of Tokyo Hospital, Tokyo, Japan
*
Akiko Kanehara, Department of Youth Mental Health, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8655, Japan. Email: [email protected]
Rights & Permissions [Opens in a new window]

Abstract

Core share and HTML view are not available for this content. However, as you have access to this content, a full PDF is available via the ‘Save PDF’ action button.
Background

Repeated drug overdose is a major risk factor for suicide. Data are lacking on the effect of psychiatric intervention on preventing repeated drug overdose.

Aims

To investigate whether psychiatric intervention was associated with reduced readmission to emergency centres due to drug overdose.

Method

Using a Japanese national in-patient database, we identified patients who were first admitted to emergency centres for drug overdose in 2010–2012. We used propensity score matching for patient and hospital factors to compare readmission rates between intervention (patients undergoing psychosocial assessment) and unexposed groups.

Results

Of 29 564 eligible patients, 13 035 underwent psychiatric intervention. In the propensity-matched 7938 pairs, 1304 patients were readmitted because of drug overdose. Readmission rate was lower in the intervention than in the unexposed group (7.3% v. 9.1% respectively, P<0.001).

Conclusions

Psychiatric intervention was associated with reduced readmission in patients who had taken a drug overdose.

Type
Research Article
Creative Commons
Creative Common License - CCCreative Common License - BYCreative Common License - NCCreative Common License - ND
This is an open access article distributed under the terms of the Creative Commons Non-Commercial, No Derivatives (CC BY-NC-ND) licence (http://creativecommons.org/licenses/by-nc-nd/4.0/).
Copyright
Copyright © The Royal College of Psychiatrists 2015

Footnotes

Declaration of interest

None.

References

1 Brådvik, L, Mattisson, C, Bogren, M, Nettelbladt, P. Long-term suicide risk of depression in the Lundby cohort 1947–1997 – severity and gender. Acta Psychiatr Scand 2008; 117: 185–91.CrossRefGoogle ScholarPubMed
2 Crandall, C, Fullerton-Gleason, L, Aguero, R, LaValley, J. Subsequent suicide mortality among emergency department patients seen for suicidal behavior. Acad Emerg Med 2006; 13: 435–42.CrossRefGoogle ScholarPubMed
3 Haukka, J, Suominen, K, Partonen, T, Lönnqvist, J. Determinants and outcomes of serious attempted suicide: a nationwide study in Finland, 1996–2003. Am J Epidemiol 2008; 167: 1155–63.CrossRefGoogle ScholarPubMed
4 Christiansen, E, Jensen, BF. Risk of repetition of suicide attempt, suicide or all deaths after an episode of attempted suicide: a register-based survival analysis. Aust NZ J Psychiatry 2007; 41: 257–65.CrossRefGoogle ScholarPubMed
5 Cooper, J, Kapur, N, Webb, R, Lawlor, M, Guthrie, E, Mackway-Jones, K, et al. Suicide after deliberate self-harm: a 4-year cohort study. Am J Psychiatry 2005; 162: 297303.CrossRefGoogle ScholarPubMed
6 Hawton, K, Zahl, D, Weatherall, R. Suicide following deliberate self-harm: long-term follow-up of patients who presented to a general hospital. Br J Psychiatry 2003; 182: 537–42.CrossRefGoogle ScholarPubMed
7 Owens, D, Horrocks, J, House, A. Fatal and non-fatal repetition of selfharm: systematic review. Br J Psychiatry 2002; 181: 193–9.CrossRefGoogle ScholarPubMed
8 Zahl, D, Hawton, K. Repetition of deliberate self-harm and subsequent suicide risk: long-term follow-up study in 11,583 patients. Br J Psychiatry 2004; 185:70–5.CrossRefGoogle Scholar
9 Gunnell, D, Bennewith, O, Peters, TJ, Stocks, N, Sharp, DJ. Do patients who self-harm consult their general practitioner soon after hospital discharge? A cohort study. Soc Psychiatry Psychiatr Epidemiol 2002; 37: 599602.CrossRefGoogle ScholarPubMed
10 Runeson, B, Tidemalm, D, Dahlin, M, Lichtenstein, P, Långström, N. Method of attempted suicide as predictor of subsequent successful suicide: national long term cohort study. BMJ 2010; 341: c3222.CrossRefGoogle ScholarPubMed
11 Horrocks, J, Price, S, House, A, Owens, D. Self-injury attendances in the accident and emergency department: clinical database study. Br J Psychiatry 2003; 183: 34–9.CrossRefGoogle ScholarPubMed
12 National Institute for Health and Clinical Excellence. Self-Harm in Over 8s: Short-Term Management and Prevention of Recurrence. NICE, 2004 (http://www.nice.org.uk/guidance/cg16).Google Scholar
13 Royal College of Psychiatrists. Assessment Following Self-Harm in Adults (Council Report CR122). Royal College of Psychiatrists, 2004.Google Scholar
14 Hickey, L, Hawton, K, Fagg, J, Weitzel, H. Deliberate self-harm patients who leave the accident and emergency department without a psychiatric assessment. A neglected population at risk of suicide. J Psychosom Res 2001; 50: 8793.CrossRefGoogle ScholarPubMed
15 Hughes, L, Kosky, N. Meeting NICE self-harm standards in an accident and emergency department. Psychiatry Bull 2007; 31: 255–8.CrossRefGoogle Scholar
16 Jones, R, Avies-Jones, A. An audit of the NICE self-harm guidelines at a local accident and emergency department in North Wales. Accid Emerg Nurs 2007; 15: 217–22.CrossRefGoogle Scholar
17 Kapur, N, Murphy, E, Cooper, J, Bergen, H, Hawton, K, Simkin, S, et al. Psychosocial assessment following self-harm: results from the multi-centre monitoring of self-harm project. J Affect Disord 2008; 106: 285–93.CrossRefGoogle ScholarPubMed
18 Okumura, Y, Shimizu, S, Ishikawa, KB, Matsuda, S, Fushimi, K, Ito, H. Characteristics, procedural differences, and costs of inpatients with drug poisoning in acute care hospitals in Japan. Gen Hosp Psychiatry 2012; 34: 681–5.CrossRefGoogle ScholarPubMed
19 Kapur, N, House, A, Dodgson, K, May, C, Creed, F. Effect of general hospital management on repeat episodes of deliberate self poisoning: cohort study. BMJ 2002; 325: 866–7.CrossRefGoogle ScholarPubMed
20 Crawford, MJ, Wessely, S. Does initial management affect the rate of repetition of deliberate self-harm? Cohort study. BMJ 1998; 317: 985.CrossRefGoogle ScholarPubMed
21 Kapur, N, Cooper, J, Hiroeh, U, May, C, Appleby, L, House, A. Emergency department management and outcome for self-poisoning: a cohort study. Gen Hosp Psychiatry 2004; 26:3641.CrossRefGoogle ScholarPubMed
22 Bergen, H, Hawton, K, Waters, K, Cooper, J, Kapur, N. Psychosocial assessment and repetition of self-harm: the significance of single and multiple repeat episode analyses. J Affect Disord 2010; 127: 257–65.CrossRefGoogle ScholarPubMed
23 Kapur, N, Steeg, S, Webb, R, Haigh, M, Bergen, H, Hawton, K, et al. Does clinical management improve outcomes following self-harm? Results from the multi-centre study of self-harm in England. PLoS One 2013; 8: e70434.CrossRefGoogle Scholar
24 Yasunaga, H, Horiguchi, H, Kuwabara, K, Matsuda, S, Fushimi, K, Hashimoto, H, et al. Outcomes after laparoscopic or open distal gastrectomy for early-stage gastric cancer: a propensity-matched analysis. Ann Surg 2013; 257: 640–6.CrossRefGoogle ScholarPubMed
25 World Health Organization. The ICD-10 Classification of Mental and Behavioural Disorders: Clinical Descriptions and Diagnostic Guidelines. WHO, 1992.Google Scholar
26 Quan, H, Sundararajan, V, Halfon, P, Fong, A, Burnand, B, Luthi, JC, et al. Coding algorithms for defining comorbidities in ICD-9-CM and ICD-10 administrative data. Med Care 2005; 43: 1130–9.CrossRefGoogle ScholarPubMed
27 D'Agostino, RB Jr. Propensity score methods for bias reduction in the comparison of a treatment to a non-randomized control group. Stat Med 1998; 17: 2265–81.Google ScholarPubMed
28 Ohta, T, Kikuchi, H, Hashi, K, Kudo, Y. Nizofenone administration in the acute stage following subarachnoid hemorrhage. Results of a multi-center controlled doubleblind clinical study. J Neurosurg 1986; 64: 420–6.CrossRefGoogle ScholarPubMed
29 Austin, PC. Using the standardized difference to compare the prevalence of a binary variable between two groups in observational research. Commun Stat Simul Comput 2009; 38: 1228–34.CrossRefGoogle Scholar
30 Kawanishi, C, Aruga, T, Ishizuka, N, Yonemoto, N, Otsuka, K, Kamijo, Y, et al. Assertive case management versus enhanced usual care for people with mental health problems who had attempted suicide and were admitted to hospital emergency departments in Japan (ACTION-J): a multicentre, randomised controlled trial. Lancet Psychiatry 2014; 3: 193201.CrossRefGoogle Scholar
31 Erlangsen, A, Lind, B, Stuart, E, Qin, P, Stenager, E, Larsen, K, et al. Short-term and long-term effects of psychosocial therapy for people after deliberate self-harm: a register-based, nationwide multicentre study using propensity score matching. Lancet Psychiatry 2015; 2:4958.CrossRefGoogle ScholarPubMed
32 Milner, AJ, Carter, G, Pirkis, J, Robinson, J, Spittal, MJ. Letters, green cards, telephone calls and postcards: systematic and meta-analytic review of brief contact Interventions for reducing self-harm, suicide attempts and suicide. Br J Psychiatry 2015; 206: 184–90.CrossRefGoogle ScholarPubMed
Submit a response

eLetters

No eLetters have been published for this article.