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Cited by 828Suicide and Self-Harm StudiesPoisoning and overdose treatmentsHomicide, Infanticide, and Child Abuse

Patterns and problems of deliberate self-poisoning in the developing world

Eddleston, M.·2000·QJM
DOI 10.1093/qjmed/93.11.715
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Abstract

Deliberate self-harm is a major problem in the developing world, responsible for around 600 000 deaths in 1990. The toxicity of available poisons and paucity of medical services ensure that mortality from self-poisoning is far greater in the tropics than in the industrialized world. Few data are available on the poisons most commonly used for self-harm in different parts of the world. This paper reviews the literature on poisoning, to identify the important poisons used for self-harm in these regions. Pesticides are the most important poison throughout the tropics, being both common and associated with a high mortality rate. In some regions, particular pesticides have become the most popular method of self-harm, gaining a notoriety amongst both health-care workers and public. Self-poisoning with medicines such as benzodiazepines and antidepressants is common in urban areas, but associated with few deaths. The antimalarial chloroquine appears the most significant medicine, self-poisoning being common in both Africa and the Pacific region, and often fatal. Paracetamol (acetaminophen) is used in many countries but in few has it reached the popularity typical of the UK. Domestic and industrial chemicals are responsible for significant numbers of deaths and long-term disabilities world-wide. Self-poisoning with plant parts, although uncommon globally, is locally popular in some regions. Few of these poisons have specific antidotes. This emphasizes the importance of determining whether interventions aimed at reducing poison absorption actually produce a clinical benefit, reducing death and complication rates. Future research to improve medical management and find effective ways of reducing the incidence of self-harm, together with more widespread provision of interventions proven to be effective, could rapidly reduce the number of deaths from self-poisoning in the developing world.

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Crossref · 10.1093/qjmed/93.11.715

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  • In high-income countries, drugs used in attempts to commit suicide include psychotropic drugs, analgesics, antihistamines, antidepressants, psychoactive drugs, and sedative-hypnotics.

    “In high-income countries, drugs used in attempts to commit suicide include psychotropic drugs, analgesics, antihistamines, antidepressants, psychoactive drugs, and sedative-hypnotics [15].”

    From Toxicological Findings of Self-Poisoning Suicidal Deaths: A Systematic Review by Countries (2022) · cites this paper as [15]

  • Rates of suicide by consuming poison are higher in developing countries, especially suicide by consuming a pesticide.

    “Rates of suicide by consuming poison are higher in developing countries, especially suicide by consuming a pesticide.”

    From Toxicological Findings of Self-Poisoning Suicidal Deaths: A Systematic Review by Countries (2022) · cites this paper as [15]

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Authors
Eddleston, M.
Affiliations
University of Oxford (GB)
Corresponding author
Eddleston, M.
ORCID
Eddleston, M.
Venue
QJM
Publisher
Oxford University Press (OUP)
Published
2000-11-01
Volume
93
Issue
11
Pages
715-731
ISSN
  • 0033-5622 (ISSN-L)
  • 1460-2393
DOI
10.1093/qjmed/93.11.715
OpenAlex
W2050617259
Cited by
828
References
1
Citations by year
2026: 6 · 2025: 18 · 2024: 31 · 2023: 23 · 2022: 31 · 2021: 37 · 2020: 34 · 2019: 30 · 2018: 30 · 2017: 41 · 2016: 34 · 2015: 31 · 2014: 39 · 2013: 37 · 2012: 42
FWCI
10.69
Type
journal article
Language
en
Open access
closed
Locations
  • QJM (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Social Sciences › Psychology › Clinical Psychology › Suicide and Self-Harm Studies
  • Health Sciences › Medicine › Emergency Medicine › Poisoning and overdose treatments
  • Social Sciences › Sociology and Political Science › Homicide, Infanticide, and Child Abuse
Keywords
self-poisoning, self-harm, developing countries, pesticides, chloroquine, paracetamol, benzodiazepines, antidepressants, plant poisoning, antidotes, poisoning mortality
MeSH terms
Adolescent, Adult, Aged, Antidotes, Attitude of Health Personnel, Caustics, Child, Child, Preschool, Detergents, Developing Countries, Female, Fuel Oils, Humans, Infant, Male, Medicine, Traditional, Middle Aged, Pesticides, Poisoning, Agrochemicals, Self-Injurious Behavior, Drug-Related Side Effects and Adverse Reactions

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