Examination of the psychiatric conditions of patients admitted to the emergency department due to drug overdose

Introduction and Aim: Emergency department presentations due to drug overdose have become a significant element of healthcare systems. Although drug overdoses have various causes, they are considered as a serious public health problem. Psychiatric disorders can be a decisive factor in the occurrence of such emergencies. These patients are usually initially evaluated by emergency medicine physicians, and the treatment process generally requires a multidisciplinary approach where medical and mental health treatments are integrated. In this study, we aimed to evaluate the demographic characteristics and mental health status of patients admitted to the emergency department due to drug overdose. Materials and Methods: In this study, patients admitted to the Emergency Department of Akdeniz University Hospital due to drug overdose between January 1, 2018, and December 31, 2022, were retrospectively screened using the hospital information management system. Patients aged 18 and over with complete data were included in the study. The demographic data, vital signs at the time of admission, information on the drugs taken and their quantities, consultation details, reasons for drug intake, previous drug overdose histories, psychiatric disease histories, psychiatric conditions, treatment information, whether the drug was in a toxic dose, emergency department follow-ups, and outcomes were evaluated. Results: It was found that out of the 769 patients included in the study, 267 were male (34.7%), and 502 were female (65.3%). The mean age of the patients was found to be 31.68±12.44. 604 patients (78.5%) took drugs with the intention of suicide. Of the patients, 185 (24.1%) had a history of previous drug overdose, and 365 (47.5%) had a history of psychiatric illness. Consultation with psychiatry was requested for 627 patients (81.5%). When the mental status of patients for whom psychiatric consultation was requested was evaluated, impulsive suicide attempts were considered in 447 patients (71.3%), and depressive disorder was considered in 44 patients (7%). The distribution of patients according to the drug groups they took revealed that 215 patients (14.8%) took NSAIDs alone or in combination with NSAIDs, 68 patients (4.7%) took combinations including paracetamol, 92 patients (6.3%) took drugs containing paracetamol alone, 219 patients (15.1%) took antidepressants, and 127 patients (8.7%) took antipsychotic drugs. As for treatment, 227 patients (29.5%) received only activated charcoal, 177 patients (23.0%) received activated charcoal and gastric lavage together, and 202 patients (26.3%) received only symptomatic treatment. While 262 patients (34.1%) took a toxic dose of the drug, 455 patients (59.2%) took a non-toxic dose. The highest rate of emergency department admissions occurred in the summer months (26.3%); the average length of stay in the emergency department was determined as 250.35±332.56 minutes. Looking at the outcomes of the patients, 199 (25.9%) were discharged, 136 (17.7%) left the hospital without permission, 61 patients (7.9%) were admitted to intensive care units, 338 patients (43.9%) were admitted to regular inpatient wards, and 35 patients (4.6%) were referred. Conclusion: Managing patients admitted to the emergency department due to drug overdose is a challenging and multidisciplinary process. A correct approach would involve more frequent mental health check-ups through psychiatric evaluations, increasing adherence to treatment, and developing more strategies to prevent the recurrence of drug overdose.