Neuropsychiatric Disease and Treatment (Jan 2019)
Psychiatric comorbidities in patients with intentional methanol intoxication
Abstract
Wei-Sheng Yang,1,2 Tzung-Hai Yen,2,3 Yeong-Yuh Juang,4 Shwu-Hua Lee,1,2 Bi-Hwa Wang,5 Chin-Pang Lee1,2 1Department of Psychiatry, Chang Gung Memorial Hospital, Linkou, Taoyuan, Taiwan; 2School of Medicine, College of Medicine, Chang Gung University, Taoyuan, Taiwan; 3Department of Nephrology and Clinical Poison Center, Chang Gung Memorial Hospital, Linkou, Taiwan; 4Department of Psychiatry, Koo Foundation Sun Yat-Sen Cancer Center, Taipei, Taiwan; 5School of Nursing, College of Medicine, Chang Gung University, Taoyuan, Taiwan Background: Intentional methanol intoxication (IMI) is an emerging public health issue in Asian countries, but few data are available in the literature on underlying psychiatric comorbidities in these suicide attempters.Patients and methods: We conducted a retrospective chart review on patients with methanol intoxication (MI) treated at Chang-Gung Memorial Hospital, Linkou, Taiwan during 2000–2016. Of the 56 cases of documented MI, 16 were IMI. Baseline demographic, clinical, laboratory, psychiatric diagnoses, and mortality data were collected and analyzed.Results: Patient group with IMI had more females (62.5% vs 7.5%, P=0.000), less alcohol consumption (33.3% vs 92.5%, P=0.000), and less smoking (40.0% vs 79.5%, P=0.009), but higher past psychiatric disease (73.3% vs 10.0%, P=0.000) and past suicide attempts (81.1% vs 2.5%, P=0.000) than patient group with unintentional MI (UMI). Pesticides (50.0%) comprised the most common source used for suicide, followed by industrial methanol (37.5%). There was no significant difference in mortality rates between these two group (25.0% vs 22.5%, P=0.548). Twelve (75.0%) survivors of IMI were referred to a psychiatric consultation-liaison team, and depressive disorder (58.3%) and adjustment disorder (25.0%) were common.Conclusion: There is a female predominance and a high prevalence of psychiatric comorbidities, namely depression and adjustment disorder in patients with IMI. Besides, alcohol consumption is a prevalent but not adequately treated condition in UMI group. Keywords: alcohol, suicide, methanol intoxication, pesticide, depression