Psychiatric Assessment of Cases with Self-inflicted Poisoning in a Sample of Egyptian Children and Adolescents

Abstract

Introduction

Suicide in children and adolescents is commonly under-reported and studied. It is an interplay area of multiple static (socio-demographic), and modifiable (impulsivity, psychiatric. morbidities, adverse. life events (ALE),abuse, bullying.) variables.

Objectives and Aim

To assess and identify relative significance of dependent and independent risk factors in youngsters attempting self-inflicted poisoning.

Methods

Consecutive recruitment of patients aged 7-18, with normal IQ, admitted to poison control center over 13 continuous months, with self-induced poisoning. All were assessed after guardians’ written informed consent for different risk factors identified for suicidal behavior using appropriate scales (Pediatric Psychiatric Sheet(PPS), Fahmy and Sherbini Social Classification Scale (FSSCS), SRRS-Y, BIS-11, J-TCI, Mini-Kid). Controls with no history of suicidal attempt were matched for age, sex. and socio-demographics among their families.

Results

A120 cases (16.7 years ± 1.6 SD, 91% females) and 100 controls (16.4 years ±1.7 SD, 90.8% females) were assessed. In cases, 90.8% were of low- middle socioeconomic status, 73.5% had previous attempt, average within 10 months, 17.5% planned their attempt, 10.8% had a witnessed attempt. Stressor within 2 days was reported in 75.9%, severe in 40%. Impulsivity was more in its cognitive, planning and motor components (P= 0.001 in each) among attempters. Cases scored more on Novelty seeking, Harm avoidance and Reward dependence than controls who had more persistence, self-directedness and cooperativeness. Attempters had significantly more past medical and psychiatric history (P=0.001, 0.05 respectively), 77.5% had a working psychiatric illness, 2% in controls.

Conclusion

Repeated suicidal attempts were the majority, with impulsivity as a predictive risk, especially if psychiatric morbidity or ALE in youths were encountered.