RESUMO
Suicide can be conceptualized as deviated behavior to way out of a problem that is causing suffering, associated with feelings of despair and hopelessness. Deliberate self poisoning is a frequent mean for committing suicide worldwide and in developing countries. Progress continues in research into the biological, psychological and social causes of suicide. The aim of the study was to provide socio-demographic circumstances, clinical severity characters, psychiatric assessment and outcomes of intentional self poisoned cases. The study was carried out on suicide poisoned cases [232 cases] admitted to Menoufiya poisoning control center throughout the year 2004. The study reflects the prevalence of suicide poisoned cases that represented 12.35% of all admitted cases [1852 cases] despite of the behavior, psychic built of Egyptian community and the religious factors that condemn for committing suicide. The highest rate of admission was during September. The most vulnerable age group was that of l9-<36years commonly female gender and singles. 52.6% of the represented cases were unemployed. So stress in society affecting the most vulnerable sensitive young adults, who are usually have little experience in dealing with problems e.g. as failure in love affair or forcing a female to go married to a dislike person are the factors attributable to the problem. Suicidal cases from rural and urban areas were nearly equal. 99.2% of the studied cases committed suicide in the victim's home by oral ingestion and most commonly by cholinergic insecticides. 43.9% of the cases were more significant at age group 7-<19 years while significant use of drugs to attempt suicide was at age group >50 years. The majority of cases in this study were of mild clinical severity [71.1%] and cholinergic insecticides poisoning was significantly represented with all clinical severity grades [mild, moderate and severe]. The high percentage of mild cases and the low I mortality rate [0.86%] may indicate that most of the studied cases didn't really want to kill themselves but only aimed at gaining attention. The present study revealed significant increase of emotional motives for suicide in females in age group 7-<19 years as within this age group; there are many emotional and psychological changes and troubles to females rendering them prone to suicidal tendency. Psychopathological study by psychiatrist was done on 193 cases i.e 83.2% of the total self-deliberate poisoning cases. 24.9% of psychoanalyzed cases had planned for suicide while 75.1% of the studied cases were impulsive. Most of the cases had mild attempt degree, believed that they would be saved [60.1%], [62.7%] respectively. Only 5.2% of the studied cases had previous suicide attempts. The present study revealed that about half of the psychiatric studied cases [50.3%] had depression and 37.3% suffered from agitation. This confirms the strong relationship between suicide and depression. 60.4% of the cases in the present study revealed psychiatric disorders in the form of affective disorder, personality changes and psychotic changes [26.4%], [18.8%] and [13.9%] respectively. So patients who attempt suicide may have psychiatric illness and need careful psychiatric evaluation with treatment before discharge. Regarding family history for psychiatric disorders and suicidal attempts, the present study revealed that 22.8% of the studied psychiatric cases had family history for suicidal attempt, and 18.6% of cases had members of their family received psychiatric treatment. This may reflect genetic predisposition for attempting suicide. So, it is recommended to alarm the people about the dangers of drug overdoses and the toxicity of cholinergic insecticides with restriction of the use of the dangerous toxic types for licensed especial issues. Also, self-deliberated poisoned patients are determined as medically fit for discharge by both toxicologist and psychiatrist Researches to improve management and find out ways of reducing deliberate self harm are urgently required. Keywords: self- deliberate Poisoning - suicide - demographic - cholinergic insecticides. Psychiatric