Trends in self-poisoning and psychotropic drug use in people aged 5-19 years: a population-based retrospective cohort study in Australia.

Abstract

OBJECTIVES:

To characterise trends in self-poisoning and psychotropic medicine use in young Australians.

DESIGN:

Population-based retrospective cohort study.

SETTING:

Calls taken by the New South Wales and Victorian Poisons Information Centres (2006-2016, accounting for 70% of Australian poisoning calls); medicine dispensings in the 10% sample of Australian Pharmaceutical Benefits Scheme data (July 2012 to June 2016).

PARTICIPANTS:

People aged 5-19 years.

MAIN OUTCOME MEASURES:

Yearly trends in intentional poisoning exposure calls, substances taken in intentional poisonings, a prevalence of psychotropic use (dispensing of antidepressants, antipsychotics, benzodiazepines and medicines for attention deficit hyperactivity disorder (ADHD)).

RESULTS:

There were 33 501 intentional poisonings in people aged 5-19 years, with an increase of 8.39% per year (95% CI 6.08% to 10.74%, p<0.0001), with a 98% increase overall, 2006-2016. This effect was driven by increased poisonings in those born after 1997, suggesting a birth cohort effect. Females outnumbered males 3:1. Substances most commonly taken in self-poisonings were paracetamol, ibuprofen, fluoxetine, ethanol, quetiapine, paracetamol/opioid combinations, sertraline and escitalopram. Psychotropic dispensing also increased, with selective serotonin reuptake inhibitors (SSRIs) increasing 40% and 35% July 2012 to June 2016 in those aged 5-14 and 15-19, respectively. Fluoxetine was the most dispensed SSRI. Antipsychotics increased by 13% and 10%, while ADHD medication dispensing increased by 16% and 10%, in those aged 5-14 and 15-19, respectively. Conversely, dispensing of benzodiazepines to these age groups decreased by 4% and 5%, respectively.

CONCLUSIONS:

Our results signal a generation that is increasingly engaging in self-harm and is increasingly prescribed psychotropic medications. These findings indicate growing mental distress in this cohort. Since people who self-harm are at increased risk of suicide later in life, these results may foretell future increases in suicide rates in Australia.

• Authors: Rose Cairns, Emily A Karanges, Anselm Wong, Jared A Brown, Jeff Robinson, Sallie-Anne Pearson, Andrew H Dawson, Nicholas A Buckley
• Journal: BMJ open (BMJ Open) Vol. 9 Issue 2 Pg. e026001 (02 20 2019) ISSN: 2044-6055 [Electronic] England
• PMID: 30787095 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
• Copyright: © Author(s) (or their employer(s)) 2019. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.

Chemical References

• Psychotropic Drugs
• Benzodiazepines

Topics

• Adolescent
• Age Distribution
• Attention Deficit Disorder with Hyperactivity (drug therapy, epidemiology)
• Australia (epidemiology)
• Benzodiazepines (poisoning)
• Child
• Child, Preschool
• Drug Prescriptions (statistics & numerical data)
• Female
• Humans
• Male
• Poisoning (epidemiology, etiology)
• Psychotropic Drugs (poisoning)
• Regression Analysis
• Retrospective Studies
• Self-Injurious Behavior (epidemiology)
• Sex Distribution
• Young Adult