Suicidal contingent in the overall structure of poisoning in Russia
Authors: Zotov P.B. , Mateikovich E.A. , Reichert L.I. , Sakharov S.P. , Suldin A.M. , Prilenskaya A.V. , Bratova O.V. , Legalova T.V. 
Published: December 2024

Individuals who commit deliberate self-poisoning for suicidal reasons make up at least a quarter of the contingent of toxicology centers in Russia, which indicates the scale of the problem. The suicidal contingent differs from unintentional victims in a number of key indicators. Women predominate among those who commit suicide (up to 73%), with the mean age of 32.5 years. There is a high proportion of unmarried – 31-45%, divorced – 6.3% people, a significant proportion are unemployed (39.5%). Upon admission to hospital, 70.2% are diagnosed with neurotic and stress-related disorders (F40-F48). Often, victims are examined by a psychiatrist or clinical psychologist not on the first day, when the most complete picture is needed to make a correct diagnosis. It is assumed that many are not diagnosed with depression. Alcohol is detected in a third of suicide attempters. The motives are predominantly interpersonal conflicts, less often they report the loss of a loved one, somatic disease, in isolated cases productive psychopathological symptoms can be found. Often the motives cannot be established. In 80-87% of attempts, medication is used. Psychotropic drugs (21.6-55.4%), cardiotropic drugs (22.5%), analgesics and antispasmodics (up to 12.5%) predominate. At least a third of suicide
victims (36%) use combined medication, which usually entails increased toxic effects. For a number of territories of the country, the use of acids and alkalis (mainly acetic acid) remains relevant – up to 6-7%, poisoning with which determines high mortality. Intentional poisonings with inhalants (carbon monoxide, helium, etc.) are isolated cases. Mortality is on average 1.7-3.1%. The diagnosis of poisoning, especially committed for suicidal reasons, is not always obvious and simple. At the time of the initial examination, 61.5% of patients do not have pronounced clinical manifestations of acute poisoning. Often, victims deny what they did, which
requires a more thorough questioning, examination, involvement of other people and objective data. Therefore, when making a diagnosis, it is recommended to use the principle of the "toxicological diagnostic triad": 1) the presence of a toxicological anamnesis; 2) toxicological situation and 3) a characteristic clinical picture, in combination with the fourth (4) task – identifying suicidal history and motives. Conclusion. In order to reduce the number of poisonings for suicidal reasons, a comprehensive system of measures is needed with
broader involvement of mental health specialists, social workers, teachers, improvement of the work of the media and Internet resources. Among the key tasks are training and broader educational work on preventive suicidology among medical personnel, psychologists, social workers, volunteers providing assistance in cases of deliberate self-poisoning, the formation of a multi-level system of suicidological alertness for the purpose of earlier identification of this category of people, providing them with assistance and preventing tragic consequences.
Keywords: suicidal poisoning, deliberate poisoning, poisoning for suicidal reasons, drug poisoning, suicide attempt, diagnosis of suicidal poisoning, poisoning prevention, suicide prevention