Mechanical ventilation as an indicator of somatic severity of self-poisoning: implications for psychiatric care and long-term outcomes.

Br J Psychiatry

Elodie Baer, MD, Department of Medical Intensive Care and Hyperbaric Medicine, Angers University Hospital, Angers; Carole Barré, MD, Department of Psychiatry, Angers University Hospital, Angers; Carole Fleury, MD, Department of Medical Intensive Care and Hyperbaric Medicine, Angers University Hospital, Angers; Claire de Montchenu, MD, Department of Psychiatry, Angers University Hospital, Angers; Jean-Bernard Garré, MD, Department of Psychiatry, Angers University Hospital, Angers; Nicolas Lerolle, MD, PhD, Department of Medical Intensive Care and Hyperbaric Medicine, Angers University Hospital, Angers; Bénédicte Gohier, MD, PhD, Department of Psychiatry, Angers University Hospital, Angers, France.

Published: March 2016

Background: Somatic severity of a self-poisoning episode varies widely between patients.

Aims: To determine the correlates (psychiatric profiles, long-term outcome) of mechanical ventilation used as a proxy to define somatic severity during a self-poisoning.

Method: All patients who required mechanical ventilation were pair-matched with ones who did not for age, gender and presence of psychiatric history. One year after the self-poisoning episode, patients were interviewed using the Hospital Anxiety and Depression Scale (HADS) and a quality-of-life assessment questionnaire (Short-Form 12 Health Survey).

Results: The ventilation group (n = 99) more frequently had mood disorders and less frequently had adjustment disorders (P = 0.007), with a higher depression score on the HADS (P = 0.01) than those in the non-ventilation group (n = 97). Survival curves showed lower survival in the ventilation group (P = 0.03).

Conclusions: Requirement for mechanical ventilation following self-poisoning is associated with a high prevalence of mood disorders and poor long-term outcome.

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http://dx.doi.org/10.1192/bjp.bp.114.154898DOI Listing

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