Demographic, Psychiatric, and Toxicological Factors Associated With Intentional Poisoning: A Cross‐Sectional Study of Hospital Emergency Department Registry Data

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Abstract
Background and Aims: Intentional poisoning is a major public health challenge requiring rapid emergency intervention. This study aimed to identify demographic, psychiatric, and toxicological factors associated with intentional poisoning among patients presenting to a hospital emergency department. Methods: We conducted a retrospective cross‐sectional analysis of 658 poisoning cases recorded in a hospital emergency department poisoning registry in Ilam, Iran (March 2022–March 2023), with linked medical‐record data reviewed after the index encounter. The primary outcome was a final binary classification of intentional versus unintentional poisoning. Categorical associations were examined using Pearson chi‐square tests or Fisher exact tests as appropriate. A multivariable logistic regression model included five prespecified clinical/psychiatric variables and estimated adjusted odds ratios (aORs) with 95% confidence intervals (CIs). Analyses used Stata version 11.0 ( α = 0.05, two‐sided). Results: Of 658 patients, 367 (55.8%) were classified as intentional poisoning and 291 (44.2%) as unintentional. Intentional poisoning was more frequent among women than men (194/279, 69.5% vs. 173/379, 45.6%; p < 0.001) and among urban than rural residents (295/476, 62.0% vs. 72/182, 39.6%; p < 0.001). In the multivariable clinical model, previous suicide attempt showed the strongest association with intentional poisoning (aOR 4.69, 95% CI 2.55–8.61, p < 0.001), and psychiatric disorder history remained associated (aOR 1.78, 95% CI 1.02–3.12, p = 0.043); current psychiatric disorder did not remain independently associated after mutual adjustment (aOR 0.91, 95% CI 0.59–1.40, p = 0.669). Among specific agents, high intentional‐use proportions were observed for aluminum phosphide (17/18, 94.4%), antibiotics (13/15, 86.7%), and acetaminophen (35/43, 81.4%). Conclusions: Intentional poisoning was associated with distinct demographic patterns and psychiatric vulnerability, particularly a history of previous suicide attempts. These findings support systematic mental health assessment in emergency poisoning care and prevention strategies focused on patients with established self‐harm history and access to highly lethal agents.

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