INTRODUCTION: The rising rate of adolescent suicide, and the burden of self-harm and mental health disorders, pose significant threats to Singapore's future health outcomes and human potential. This study sought to examine the risk profile and healthcare utilisation patterns of Singaporean adolescents who presented to the emergency department (ED) for suicidal or self-harm behaviour. METHOD: A retrospective review of medical records for patients aged 10 to 19 years who visited Singapore's KK Women's and Children's Hospital ED for suicidal or self-harm attempts from January to December 2021 was conducted. RESULTS: A total of 221 patients were identified, with a predominance of female patients (85.5%) over males (14.5%). The mean age was 14.2 ± 1.4 years. Intentional drug overdose (52.0%) was the most commonly used method. Significantly more females presented for intentional paracetamol overdose (46.6% versus [vs] 28.1%, P=0.049), whereas jumping from a height was more common among males (18.8% vs 5.8%, P=0.022). The most frequently observed mental health challenges were stress-related and emotional coping difficulties (50.7%), followed by mood and anxiety symptoms (53.4%). A history of self-harm and suicidal behaviours were the most common psychosocial risk factors. Within the year prior to their ED presentation, 15.4% had accessed healthcare services for mild medical ailments, 19.5% for medically unexplained symptoms, and 17.2% for previous self-harm or suicide attempts. CONCLUSION Most cases involved psychosocial and emotional regulation difficulties, some of which displayed sex-specific patterns, rather than complex psychiatric disorders. The identified predictive factors can help inform Singapore's National Mental Health and Well-being Strategy, to guide targeted and transdiagnostic interventions in schools and community settings.
Humans ; Adolescent ; Singapore/epidemiology* ; Female ; Male ; Suicide, Attempted/psychology* ; Emergency Service, Hospital/statistics & numerical data* ; Self-Injurious Behavior/psychology* ; Retrospective Studies ; Child ; Young Adult ; Drug Overdose/epidemiology* ; Risk Factors ; Acetaminophen/poisoning* ; Patient Acceptance of Health Care/statistics & numerical data* ; Sex Factors

INTRODUCTIONPaediatric poisoning accounts for 1% of daily emergency department presentations. The aim of this study was to review the characteristics and outcomes of paediatric patients who presented with drug overdose over a five-year period.

METHODSWe performed a retrospective review of paediatric poisoning cases at KK Women's and Children's Hospital (KKH), the largest children's public hospital in Singapore, from 1 January 2009 to 31 December 2013.

RESULTSA total of 1,208 cases of poisoning were seen in KKH's Department of Children's Emergency during the study period. The gender distribution was about equal, with a slight male predominance. The majority of the poisoning cases were accidental. Slightly more than half of the intentional ingestions were of paracetamol and the majority were female patients belonging to the 12-16 year age group. The bulk of poisonings occurred in children aged 1-4 via the oral route, slightly more than half of the oral ingestions consisted of oral medications and a sizeable portion were of household liquids. Mothballs and silica gels accounted for almost a quarter of the solid household products ingested. Slightly less than half of the patients required admission and only a small portion of the admitted patients required intensive or high dependency care.

CONCLUSIONThe prognosis of paediatric patients who presented with poisoning in our study was good, with a short median length of stay for those admitted and no fatalities being reported across the span of five years.

Acetaminophen ; Adolescent ; Adult ; Child ; Child, Preschool ; Critical Care ; Drug Overdose ; epidemiology ; Emergency Service, Hospital ; organization & administration ; Female ; Hospitalization ; Hospitals, Pediatric ; organization & administration ; Humans ; Infant ; Infant, Newborn ; Intensive Care Units ; Length of Stay ; Male ; Poisoning ; epidemiology ; Prognosis ; Retrospective Studies ; Silicon Dioxide ; Singapore ; epidemiology

Adolescent ; Adult ; Aged ; Aged, 80 and over ; Child ; Child, Preschool ; China ; epidemiology ; Drug Overdose ; epidemiology ; Female ; Hospitals, General ; statistics & numerical data ; Humans ; Infant ; Male ; Middle Aged ; Poisoning ; epidemiology ; Young Adult

INTRODUCTIONParacetamol is available as an over-the-counter medication in many countries including Malaysia. This drug has been implicated in many poisoning cases admitted to hospitals throughout the country.

METHODSWe conducted a three-year retrospective review of 165 medical records of patients admitted to the Penang General Hospital for acute paracetamol poisoning. Cases were identified according to the discharge diagnosis documented in their medical records.

RESULTSAcute paracetamol poisoning occurred in all major ethnic groups. About 70 percent of our patients were female. There was minimal involvement of children. Admissions were more likely to be due to deliberate ingestions rather than accidental poisoning. In most cases, serum concentrations data plotted on the Rumack-Matthew nomogram predicted the majority of cases to be unlikely to be hepatotoxic, which were consistent with their mild clinical courses. Patients who acutely ingested more than 140 mg/kg or predicted to be hepatotoxic, based on their serum concentrations, had a significantly longer hospital stay.

CONCLUSIONAlthough acute paracetamol poisoning was common, the outcome was generally good.

Acetaminophen ; poisoning ; Adolescent ; Adult ; Aged ; Child ; Child, Preschool ; Dose-Response Relationship, Drug ; Drug Overdose ; epidemiology ; therapy ; Female ; Humans ; Infant ; Infant, Newborn ; Malaysia ; epidemiology ; Male ; Middle Aged ; Nomograms ; Retrospective Studies ; Treatment Outcome