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The number of teenage poisonings over the past 20 years in the UK has risen sharply, particularly among girls, according to a new study by researchers at The University of Nottingham.
The study is the largest of its kind and also reveals that those teenagers living in the most deprived areas of the UK are 2 to 3 times as likely to poison themselves, either deliberately or unintentionally, compared to teenagers in the least deprived areas. The research is published online in the BMJ’s Injury Prevention.
Poisoning is one of the most common causes of death among teens worldwide, with much of it related to self–harm, which in turn is often closely linked to mental health problems.
Trends over time
Most of the evidence on the incidence and risk factors for poisonings is restricted to data on hospital admissions or emergency care visits, with little information on time trends.
In a bid to rectify this, the researchers reviewed anonymised general practice records submitted to the UK Health Improvement Network database (THIN) between 1992 and 2012 on poisonings—both deliberate and unintentional—for more than 1.3 million 10 to 17 year olds.
In all, there were 17,862 cases of poisoning among the teens between 1992 and 2012.
They calculated the incidence rates per 100,000 person years—in other words, the number of poisonings occurring in 100,000 young people in a year—for all poisonings; intentional poisonings; unintentional poisonings; those of unknown intent; and alcohol related poisonings, broken down by age, sex, calendar period and level of socioeconomic deprivation, as measured by the Townsend Index.
Gender divide
Leading the research, Dr Edward Tyrrell from the University’s Division of Primary Care, said: “Our analysis revealed that the overall numbers of new cases of recorded teen poisonings rose by 27% between 1992 and 2012 from 264.1/100,000 person-years to 346.8/100,000 person–years.
“The largest increases during this period were seen for intentional poisonings among 16-17 year old girls and for alcohol related poisonings among 15-16 year old girls, both of which roughly doubled.
“Between 2007 and 2012 almost two thirds (64%) of poisonings were recorded as intentional, with only 4% unintentional. Some 16% were related to alcohol, while the intent was unknown in 16% of cases.
“There was a clear gender divide in the poisoning rates, with sex differences in intentional and alcohol related poisonings widening over time. The rate of poisoning in boys/young men was less than half that in girls/young women, and this was particularly true of intentional poisonings which were 80% lower in boys/young men. Alcohol related poisonings were 10% lower in boys/young men.”
Deprivation link
The study concludes that overall rates were strongly linked to socioeconomic deprivation, with those from the most deprived areas two to three times more likely to have a poisoning than those from the least deprived areas. The link with poverty and deprivation did not reduce over time, and may reflect a difference in levels of mental anguish, stress, and social and psychological support.
Dr Tyrrell said there are caveats to the findings. “We must consider whether this [the increasing rates seen among young women] reflects real changes, increased health seeking behaviour or changes in GP coding practices, or popular trends, such as clinicians perceiving intentional poisonings as more frequent and therefore recording events as such.
“One potential explanation for the increase in alcohol poisonings over time is increased availability, with the relative affordability of alcohol in the UK increasing steadily between 1980 and 2012, licensing hours having increased since 2003, and numbers of outlets increasing alongside alcohol harm.
He concludes: “Since intentional and alcohol related adolescent poisoning rates are increasing, both child and adolescent mental health and alcohol treatment service provision needs to be commissioned to reflect this changing need. Social and psychological support for adolescents should be targeted within more deprived communities to help reduce the current social inequalities.”
Research: Changes in poisonings among adolescents in the UK between 1992 and 2012: a population based cohort study doi 10.1136/injuryprev-2015-041901 Journal: Injury Prevention
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