Intentional and Alcohol Poisonings among Adolescents Increasing Interview with:

Dr Edward Tyrrell NIHR In-Practice Research Fellow Division of Primary Care University Park Nottingham

Dr. Edward Tyrrell

Dr Edward Tyrrell
NIHR In-Practice Research Fellow
Division of Primary Care
University Park Nottingham What is the background for this study?

Dr. Tyrrell: Poisonings are among the most common causes of death amongst adolescents across the world, many of them related to self-harm. Poisonings leading to death are just the tip of the iceberg with many more resulting in invasive treatment, time off school and long term health effects. Many adolescent self-harm episodes are linked to mental health problems, which are often predictive of mental health problems in adulthood, making adolescence a key window for preventative intervention. However, up to date rates and time trends for adolescent poisonings are lacking, hindering the development of evidence-informed policy and planning of services.

To quantify this problem at a national level and provide recent time trends of poisonings, we used routinely collected primary care data from 1.3 million 10-17 year olds. We assessed how intentional, unintentional and alcohol-related poisonings for adolescent males and females vary by age, how these have changed between 1992 and 2012 and whether socioeconomic inequalities exist. What are the main findings?

Dr. Tyrrell: Total recorded poisoning incidence increased by 27% from the period 1992-96 to 2007-12. However, intentional poisonings increased more sharply, by 50% over the same period across all ages combined. The biggest increases were for intentional poisonings among 16-17 year old girls and also alcohol related poisonings in girls aged 15-16, both of which roughly doubled over the period studied. We also saw a strong socio-economic gradient in poisonings, with those from the most deprived areas two to three times more likely to have a poisoning than those from the least deprived areas. What should readers take away from your report?

Dr. Tyrrell: Intentional and alcohol poisonings among adolescents are increasing. It is important that both provision of both child and adolescent mental health and alcohol treatment services reflect this changing need. Services should be targeted more at deprived areas and young girls.

Individual clinicians should be aware of the groups at highest risk, in particular 15-17 year old girls and more deprived communities and look for signs of anxiety/depression in such groups while keeping supplies of prescribed medication to a minimum. What recommendations do you have for future research as a result of this study?

Dr. Tyrrell: In the UK, information on all medical attendances should be sent back to the patient’s GP and be recorded in their electronic medical record. Although our study should give an accurate picture of poisoning changes over time, having used only one data source however, the incidence rates we report are likely to be underestimates. Additional studies using primary and secondary care data in combination would be of benefit. Is there anything else you would like to add?

Dr. Tyrrell: We must consider whether the increases in intentional poisonings we demonstrated reflect real changes, increased health seeking behaviour or improved recording, or even popular trends, such as clinicians perceiving intentional poisonings as more frequent and therefore recording events as such. The reality is likely to be a combination of all these factors. Thank you for your contribution to the community.


Changes in poisonings among adolescents in the UK between 1992 and 2012: a population based cohort study

Edward G Tyrrell, Elizabeth Orton, Laila J Tata
Inj Prev injury prev-2015-041901 Published Online First: 16 May 2016 doi:10.1136/injuryprev-2015-041901

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Last Updated on May 17, 2016 by Marie Benz MD FAAD