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Clinical characteristics of patients who attempt suicide by drug overdose in Western China: a retrospective analysis

Lingyan Li,Huaiyi Zhu,Lin Wang,Zuolin Wei,Xiaoli Wang,Yigang Li,Mingjin Huang

Published 2025 in BMC Psychiatry

ABSTRACT

Overdose is a prevalent method of suicide, and a thorough analysis of the demographic characteristics and risk behaviour patterns within the drug overdose population might facilitate the development of effective treatments and prevention methods. This retrospective study analysed patients hospitalized for attempted suicide by drug overdose (2020–2023) at a tertiary care hospital in Western China. Data on sociodemographic and clinical characteristics were analysed using descriptive statistics and multivariable logistic regression. A total of 631 overdose cases originating from 604 patients were analysed. The resulting patient cohort had a male-to-female ratio of 1:3.1. The patient age range was 12–88 years, with more than half (57.0%) aged ≤ 20 years. The number of female patients was greater than that of male patients across all age groups, with this sex disparity decreasing with increasing age. Among 631 overdose cases, 84.2% involved psychiatric drugs, with antidepressants being the predominant drug type (296 cases, 46.9%). Adult patients predominantly used benzodiazepines and had a higher rate of alcohol co-ingestion, whereas adolescent patients used antidepressants and often combined multiple medications (≥3). The number of overdose cases showed a bimodal distribution and was more pronounced in the adolescent population, with peak drug use occurring in April and December, which coincided with academic cycles. A total of 52.0% of the patients had a history of psychiatric hospitalization, with depressive disorders being the predominant mental illness. Among the follow-up destinations, 36.7% of the adult patients returned home without psychiatric follow-up after treatment, which was significantly greater than the percentage of adolescents who returned home (19.9%, p < 0.05). Multivariable analysis identified female sex (aOR = 0.56) and prior psychiatric contact (outpatient aOR = 0.12; hospitalization aOR = 0.21) as protective factors against loss to follow-up. This study identifies adolescent females and individuals with depressive disorders as key populations for targeted suicide prevention. A bimodal peak in attempts coinciding with academic examination periods (April/December) supports implementing school-based screenings and stress management. Adults showed significantly higher disengagement from follow-up, with prior psychiatric contact emerging as a protective factor. These findings underscore the need for improved care continuity, especially for individuals without established mental health pathways. Not applicable.

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