Sex differences in patients with suicidal intent that are managed by toxicologists: An analysis of the Toxicology Investigators' Consortium (ToxIC) Registry

• Published in: The American journal of emergency medicine Vol. 38; no. 2; pp. 333 - 338
• Main Authors: Beauchamp, Gillian A, Fishbein, Jacob, Makar, Gregory A, Pechulis, Rita M, Cook, Matthew D, Cannon, Robert D, Katz, Kenneth D, Kincaid, Hope, Carey, Jennifer L, Greenberg, Marna Rayl
• Format: Journal Article
• Language: English
• Published: United States Elsevier Limited 01.02.2020
• Subjects: Alcohol; Consortia; Drug use; Emergency medical care; Females; Gender; Gender differences; Males; Mental disorders; Patients; Pharmaceuticals; Poisons; Prescription drugs; Sex differences; Sexes; Statistical analysis; Suicide; Suicides & suicide attempts; Toxicology; Women; ToxIC; Suicide; Sex
• DOI: 10.1016/j.ajem.2019.158450
• ISSN: 0735-6757

The Toxicology Investigator's Consortium (ToxIC) maintains a prospective case registry of all patients that have been managed at the bedside by medical toxicologists. We set out to characterize the differences in toxicological suicide attempts between men and women among adult patients with poisonings managed by medical toxicologists. ToxIC database consults for adults aged 19-65 whose primary reasons for encounter were classified as suicide attempt were used for this study (1/2010-12/2016). Data used for analysis included primary agents of toxic exposure, routes of administration, and complications. The statistical analysis was limited to descriptive methods. Out of 51,440 registry cases, 33,259 cases remained for analysis after applying the ages 19-65 and removing those without complete data. Of these, there were 4827 suicide attempts (14.5% of toxicological exposures) which were sub classified by gender. There were more females (F) than males (M) whose toxicology consults were due to suicidal attempts (57.6% versus 42.4%). We also found that more males used alcohol as their primary agent (2.8%M v 1.5%F) or a nonpharmaceutical (%7.4 M v %2.3 F). In our study, we found that there were more females than males who attempted suicide by self-poisoning; and more of them used pharmaceuticals than males. In contrast, a greater number of males used nonpharmaceuticals such as alcohol. We did not find large sex-differences in suicide completion rates, routes of administration, or subsequent symptomologies. In summary, sex-based differences were observed between adult patients with suicidal-intent exposures/ingestions managed at the bedside by medical toxicologists.