Interaction Effects between Intentional Poison, Suicide Attempts, Psychological Disorders, and Gender Using Log-linear Models Approach

Abstract

Based on research evidence, intentional poisoning has a relatively high prevalence among people with psychiatric disorders, and the diagnosis of psychological disorders can be an important predictor of suicide attempts and their recurrence. Gender presents a determinant in the occurrence of psychiatric conditions and suicidal behaviors. This study aimed to investigate the relationship between suicide attempts, psychiatric disorders, and gender in individuals hospitalized due to intentional poisoning. This study used the data obtained from the disease registration program based on the data of the patients hospitalized due to intentional poisoning during a two-year followup (2021-2022), including a total of 658 patients. In this study, log-linear models were used to assess the relationships between the main variables that independently entered the model. The outputs of the log-linear model we reanalyzed as independent, two-way, threeway, and saturated models using relevant fit indices. Finally, the results of the best model were presented. Based on the conditional values retrieved from the final model, the risk of intentional poisoning was lower in women than in men after adjusting for the variables of a history of suicide attempts and the results of psychological assessment (OR=0.25, 95% CI: 0.16-0.37, p = < 0.001). The risk of suicide attempts in women suffering from underlying psychiatric disorders (OR=1.57, 95% CI: 0.81-2.99, p = 0.188) and in women without underlying psychiatric disease, which was not statistically significant (OR=1.07, 95% CI: 0.47-2.69, p = 0.785). Also, the results showed that the risk of psychiatric disorders in people who had a prior suicide attempt (OR= 1.88, 95% CI: 1.05-2.25, p = < 0.001) and in women (OR=1.92, 95% CI: 1.05-2.77, p = < 0.001) was statistically significant. Based on our findings, men suffering from underlying psychological disorders and prior suicide attempts had a higher risk for intentional poisoning. On the other hand, among people without a history of suicide attempts and without underlying psychological disorders, the risk of intentional poisoning was higher in women. Moreover, a positive history of suicide attempts in both genders significantly increases the risk of having a psychological disorder. Therefore, it seems that underlying psychological disorders and a positive history of suicide attempts render women more vulnerable to intentional poisoning than men. Overall, it is suggested to consider screening for psychological disorders as a preventive measure in individuals proven to have intentional poisoning and suicide attempts, especially in men.