Analysis of emergency adolescent antidepressant poisoning incidence and family psychological environment influencing factors

Abstract

BACKGROUND

The increasing prevalence of adolescent depression has led to widespread antidepressant use, with associated risks of intentional and accidental poisoning. Family dysfunction, parental mental health problems, and poor family psychological environment are known risk factors for adolescent self-harm behaviors, but their specific role in antidepressant poisoning has not been systematically investigated.

AIM

To analyze the incidence characteristics of adolescent antidepressant poisoning in emergency departments, explore the influence of family psychological environment on adolescent antidepressant poisoning, and provide scientific evidence for developing effective prevention strategies.

METHODS

A retrospective study design was employed, collecting data from 250 adolescent patients aged 12-18 years admitted to the emergency department of a hospital from January 2020 to January 2025, including 28 cases of antidepressant poisoning (poisoning group) and 222 cases of non-drug poisoning adolescent patients (normal group). Family psychological environment was assessed using Family Social Climate Questionnaire, Family Adaptability and Cohesion Evaluation Scales-II, Symptom Checklist-90, Egna Minnen Betraffande Uppfostran, Life Events Scale, and Social Support Rating Scale. Adolescent psychosocial factors were evaluated using Center for Epidemiologic Studies Depression Scale, Self-Rating Anxiety Scale, Adolescent Life Events Scale, Interpersonal Reactivity Index, and Coping Style Questionnaire. Statistical analyses included t-tests, χ² tests, and multivariate logistic regression analysis for influencing factors.

RESULTS

The incidence of adolescent antidepressant poisoning in emergency departments was 11.2% [95% confidence interval (CI): 7.8%-15.8%]. Multivariate logistic regression analysis showed that female gender [odds ratio (OR) = 2.847, 95%CI: 1.024-7.913], high Center for Epidemiologic Studies Depression Scale scores (OR = 1.124, 95%CI: 1.062-1.190), low Family Structure Characteristics Questionnaire total scores (OR = 0.934, 95%CI: 0.891-0.979), high parental Symptom Checklist-90 total scores (OR = 1.018, 95%CI: 1.005-1.031), and low Social Support Rating Scale total scores (OR = 0.895, 95%CI: 0.839-0.955) were independent influencing factors for adolescent antidepressant poisoning (all P < 0.05).

CONCLUSION

The incidence of adolescent antidepressant poisoning is relatively high, with female gender, depression severity, family structure instability, parental mental health problems, and lack of social support being important influencing factors. A family-centered multi-level comprehensive prevention and treatment system should be established, strengthening adolescent mental health screening, improving family psychological environment, and enhancing social support levels.

Keywords: Adolescents; Antidepressant drugs; Drug poisoning; Family psychological environment; Influencing factors; Emergency medicine

Core Tip: Among adolescents presenting to the emergency department, antidepressant poisoning comprised 11.2% of visits and was predominantly intentional. Multivariable analysis showed higher depressive symptoms (Center for Epidemiologic Studies Depression Scale), greater parental psychological distress (Symptom Checklist-90), lower social support (Social Support Rating Scale), and unstable family structure (Family Structure Characteristics Questionnaire) independently correlated with antidepressant poisoning, especially in females. These findings support a family-centered, bio-psycho-social prevention strategy that couples rapid emergency department screening with targeted interventions for parental mental health and adolescent social-support strengthening.