George Bailey, Fiona Wisniacki



To provide an up-to-date assessment of the demographics, patient characteristics and substances involved in deliberate self-poisoning (DSP) presentations to a UK emergency department (ED).


A retrospective observational study was undertaken at Ealing Hospital ED between 1st August 2011 and 31st July 2012. Scanned ED records were reviewed to collect data from potential DSP presentations.


368 DSP presentations were identified, accounting for 0.9% of total ED attendances. The mean age was 34.2 years and the female : male ratio 1.85 : 1. All 12 patients under 16 years were female. 561 substances were used in total. Paracetamol was the most frequently used substance, taken by 150 (40.8%) patients (with the addition of compound analgesics). The next most frequent substances were NSAIDs (16.8% of patients), hypnotics and anxiolytics (15.2%), SSRIs (13.9%), compound analgesics (8.7%) and atypical antipsychotics (8.4%). 533 (95.0%) of the substances were medications listed in the BNF. Household cleaning products were the most common of five other groups. Specific treatments were administered to 77 (20.9%) patients. 122 (33.2%) patients required specialty admission.


DSP remains a common ED presentation and presents the challenge of managing both medical complications and psychiatric risks. Observational studies on DSP are an important source of information on trends in demographics and substances; this can inform future prevention strategies. A detailed assessment of DSP presentations is provided in this study. A national surveillance system or study is recommended to improve knowledge and a consensus on classification of substances would aid comparisons between studies.


Poisoning ; deliberate self-poisoning ; deliberate self-harm ; toxicology

Full Text:



Thomas SH, Bevan L, Bhattacharyya S, et al. Presentation of poisoned patients to accident and emergency departments in the north of England. Hum Exp Toxicol 1996;15:466-70.

Cook R, Allcock R, Johnston M. Self-poisoning: current trends and practice in a UK teaching hospital. Clin Med 2008;8:37-40.

Prescott K, Stratton R, Freyer A, et al. Detailed analyses of self-poisoning episodes presenting to a large regional teaching hospital in the UK. Br J Clin Pharmacol 2009;68:260-8.

Kapur N, House A, Creed F, et al. Management of deliberate self poisoning in adults in four teaching hospitals: descriptive study. BMJ 1998;316:831-2.

Hawton K, Bergen H, Casey D, et al. Self-harm in England: a tale of three cities. Multicentre study of self-harm. Soc Psychiatry Psychiatr Epidemiol 2007;42:513-21.

National Institute for Clinical Excellence. Self-harm: The short-term physical and psychological management and secondary prevention of self-harm in primary and secondary care. 2004. (accessed 27 Feb 2013)

National Poisons Information Service. (accessed 27 Feb 2013)

Department of Health. Preventing suicide in England. 2012. (accessed 27 Feb 2013)

Office for National Statistics. Suicides in the United Kingdom, 2011. 2013. (accessed 27 Feb 2013)

Hawton K, Simkin S, Dodd S, et al. Long term effect of reduced pack sizes of paracetamol on poisoning deaths and liver transplant activity in England and Wales: interrupted time series analyses. BMJ 2013;346:f403.

Hawton K, Bergen S, Simkin S, et al. Effect of withdrawal of co-proxamol on prescribing and deaths from drug poisoning in England and Wales: time series analysis. BMJ 2009;338:b2270

Ealing Council. 2011 Census Factsheet. (accessed 12 May 2013)

British National Formulary Committee. British National Formulary, 64th ed. London, UK: Royal Pharmaceutical Society of Great Britain; British Medical Association, 2012 September.

British National Formulary Committee. Section 4.7.1. Non-opioid analgesics and compound preparations. British National Formulary, 64th ed. London, UK: Royal Pharmaceutical Society of Great Britain; British Medical Association, 2012 September: 263-268.

Wilkinson S, Taylor G, Templeton L, et al. Admissions to hospital for deliberate self-harm in England 1995-2000: an analysis of hospital episode statistics. J Public Health Med 2002;24:179-83.

Bhui K, McKenzie K, Rasul F. Rates, risk factors & methods of self harm among minority ethnic groups in the UK: a systematic review. BMC Public Health 2007;7:336.

Bhugra D, Desai M, Baldwin D, et al. Attempted suicide in west London, I. Rates across ethnic communities. Psychol Med 1999;29:1125-30.

Bhugra D, Desai M. Attempted suicide in South Asian women. Advances in psychiatric treatment 2002;8:418-23.

Neeleman J, Wessely S. Drugs taken in fatal and non-fatal self-poisoning: a study in south London. Acta Psychiatr Scand 1997;95:283-7.

Minns RF, Clark AB. Toxicology and overdose of atypical antipsychotics. J Emerg Med 2012;43:906-13.

National Poisons Information Service. Annual Report 2011/2012. Health Protection Agency. 2012.

Camidge D, Wood R, Bateman D. The epidemiology of self-poisoning in the UK. Br J Clin Pharmacol 2003;56:613-19.

Cooper J, Kapur N, Webb R et al. Suicide after deliberate self-harm: a 4-year cohort study. Am J Psychiatry 2005;162:297-303.

Runeson B, Tidemalm D, Dahlin M et al. Method of attempted suicide as predictor of subsequent successful suicide: national long term cohort study. BMJ 2010;341:c3222

British National Formulary Committee. Section 4.3. Antidepressant drugs. British National Formulary, 64th ed. London, UK: Royal Pharmaceutical Society of Great Britain; British Medical Association, 2012 September:245-248.

University of Oxford Centre For Suicide Research. Self-harm in Oxford 2010. 2010. (accessed 27 Feb 2013)


  • There are currently no refbacks.