• Mandira Hiremath, Simon Craig, and Andis Graudins.
• Emergency Department, Monash Children's Hospital, Melbourne, Victoria, Australia.
• Emerg Med Australas. 2016 Dec 1; 28 (6): 704-710.

ObjectiveTo describe the characteristics of adolescents presenting with deliberate self-poisoning (DSP) to a large Australian healthcare network.MethodThis is a retrospective chart review of 12-17 year olds presenting to three Monash Health EDs with self-poisoning from January 2012 to December 2014.ResultsThere were 35 207 adolescent presentations in the study period. A total of 721 cases were for DSP (2%), and 501 (1.4%) presented with recreational or accidental self-poisoning. The most common DSP toxicants were paracetamol (28%), non-steroidal anti-inflammatory agents (15%) and serotonin reuptake inhibitors (10%). Of the DSP presentations, 96% were impulsive events; 23% of patients (n = 129) presented on multiple occasions, and 67% of all DSP cases had a past psychiatric history, particularly depression (57%). Disposition for DSP patients included 60% discharged home, 6% short stay unit, 19% medical admission, 13% psychiatric admission and 2% intensive care unit admission. There were no mortalities.ConclusionAdolescent DSP presentations frequently involved impulsive ingestion of over-the-counter medications, suggesting less access to prescription medications. Additionally, pre-existing mental health history and re-presentation were common. Initiatives to prevent DSP might include an increased focus on the early identification and management of mental health problems in adolescents in the community.© 2016 Australasian College for Emergency Medicine and Australasian Society for Emergency Medicine.

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