Benzodiazepine therapy in psychiatric outpatients is associated with deliberate self-poisoning events at emergency depar
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ORIGINAL INVESTIGATION
Benzodiazepine therapy in psychiatric outpatients is associated with deliberate self-poisoning events at emergency departments—a population-based nested case–control study Hsin-I Shih & Ming-Chia Lin & Che-Chen Lin & Hsiang-Chin Hsu & Hsin-Ling Lee & Chih-Hsien Chi & Fung-Chang Sung & Yen-Jung Chang & Chia-Hung Kao
Received: 14 December 2012 / Accepted: 16 April 2013 # Springer-Verlag Berlin Heidelberg 2013
Abstract Rationale Deliberate self-poisoning (DSP), the most common form of deliberate self-harm, is closely associated with suicide. Identifying risk factors of DSP is necessary for implementing prevention strategies. Objectives This study aimed to evaluate the relationship between benzodiazepine (BZD) treatment in psychiatric outpatients and DSP cases at emergency departments (EDs). Methods We performed a retrospective nested case–control study of psychiatric patients receiving BZD therapy to evaluate the relationship between BZD use and the diagnosis of DSP at EDs using data from the nationwide Taiwan National Health Insurance Research Database.
Results Regression analysis yielded an odds ratio (OR) and 95 % confidence interval (95 % CI) indicating that the use of BZDs in psychiatric outpatients was significantly associated with DSP cases at EDs (OR=4.46, 95 % CI=3.59–5.53). Having a history of DSP, sleep disorders, anxiety disorders, schizophrenia, depression, or bipolar disorder was associated with a DSP diagnosis at EDs (OR=13.27, 95 % CI=8.28– 21.29; OR=5.04, 95 % CI=4.25–5.98; OR=3.95, 95 % CI= 3.32–4.70; OR=7.80, 95 % CI=5.28–11.52; OR=15.20, 95 % CI=12.22–18.91; and OR=18.48, 95 % CI=10.13– 33.7, respectively). After adjusting for potential confounders, BZD use remained significantly associated with a subsequent DSP diagnosis (adjusted OR=2.47, 95 % CI=1.93–3.17). Patients taking higher average cumulative BZD doses were at greater risk of DSP.
Hsin-I Shih and Ming-Chia Lin contributed equally to this work. H.
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