Intentional or unintentional drug poisoning in elderly people: retrospective observational study in a tertiary care hospital in Japan.

AIM: Intentional or unintentional acute drug poisoning occurs even in elderly people, but little is known about the factors influencing the intention to poisoning. A retrospective study was undertaken to describe the characteristics of acute drug poisoning in elderly people according to whether the poisoning was intentional or unintentional and the responsible agents. METHODS: The study was carried out in a single tertiary hospital in Japan. A total of 145 patients aged ≥65 years who were transferred by an ambulance service and were diagnosed with acute drug poisoning were included. Medical records were used to collect information on the intention behind poisoning and the responsible agents. Patients were divided into two groups according to whether they experienced intentional or unintentional poisoning and were further classified according to the responsible agent. Multivariable logistic regression models were used to estimate the association between hospitalization for acute drug poisoning and the use of benzodiazepine receptor agonists (BzRAs). RESULTS: Poisoning was unintentional in 102 (70.3%) patients and intentional in 43 (29.7%) patients. In total, 65 (44.8%) patients required hospitalization. Among patients in the unintentional poisoning group, those using non-BzRAs were more likely to be hospitalized than those using BzRAs (odds ratio, 6.64; 95% confidence interval, 2.56-17.22). The length of hospital stay was significantly longer in the unintentional poisoning group than in the intentional poisoning group (13.9 vs. 6.2 days; P = 0.013). CONCLUSIONS: The proportion of unintentional poisoning in the elderly is high, and particularly with respect to poisoning with non-BzRAs, the hospitalization rates are high.

[Study of the relationship between incidence of sick leave due to mental health failure and work rules about sick leave].

OBJECTIVES: This study examined the relationships among the support system for return to work, work rules about sick leave, and incidence of sick leave due to mental health failure. METHODS: A questionnaire was distributed to 150 workplaces with a history of use of the occupational health promotion center of a certain prefecture. The questionnaire asked about the number and duration of sick leaves due to mental health failure, the support system for return to work, and work rules about sick leave. RESULTS: A significant correlation between the number of permanent staff and maximum period of sick leave was found (r=0.489, p<0.001), as well as a significant correlation between the number of permanent staff and the period of monetary compensation during sick leave (r=0.315, p=0.031). In addition, in 9 workplaces with more than 1,000 permanent staff, a significant correlation between the period of monetary compensation period during sick leave and incidence of sick leave was found (r=0.670, p=0.048), as well as a significant correlation between the period of monetary compensation during sick leave and the average length of sick leave (r=0.866, p<0.001). CONCLUSIONS: The results of this study suggest the possibility that monetary compensation is associated with the duration of sick leave due to mental health failure. Hereafter, to construct a support system for mental health, consideration of the effect of monetary compensation appears to be required.

The effect of stress-related factors on mental health status among resident doctors in Japan.

OBJECTIVES: This study was designed to investigate how the interaction between the ability of medical residents (doctors in postgraduate training) to cope with stress and their working conditions might affect their level of job-related stress. METHODS: A self-administered questionnaire was distributed to 549 first-year medical residents at 38 postgraduate education hospitals in Japan, 1-2 months after the start of clinical training. The questionnaires contained the 29-item Sense of Coherence (SOC) Scale, the Brief Scales for Job Stress (BSJS), the 12-item General Health Questionnaire (GHQ-12) and questions on basic conditions such as working hours. Sense of coherence is an important concept from the viewpoint of salutogenesis theory and influences stress recognition style. People with a strong SOC have a high ability to cope with stress. RESULTS: The mean +/- standard deviation (SD) score on the SOC Scale was 134.5 +/- 20.5. All participants were classified into three groups according to their SOC Scale scores. Although the objective working conditions of the three groups were statistically similar, the group with the weakest SOC Scale score showed poorer mental health status (p < 0.05) and scored lower for 'reward from work' compared with the groups with stronger SOC scores (p < 0.05). The weaker SOC group also scored higher for 'mental workload' and 'problems in personal relationships' than the other two groups (p < 0.05). Moreover, the weak SOC group scored less for 'support from colleagues and superiors' than the strong SOC group (p < 0.05). A stepwise multiple regression analysis for GHQ-12 score was conducted (R(2) = 0.45). 'Sleep time', 'workload', 'mental workload' and 'problems in personal relationships' were positively correlated with GHQ-12 scores. 'Reward from work' was negatively correlated with GHQ-12 scores. CONCLUSIONS: Residents' mental health was associated not only with working conditions, but also with their attitudes towards those working conditions. Enhancing residents' sense of 'reward from work' might be important in reducing their reactions to stress.