{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,1]],"date-time":"2026-08-01T06:58:57Z","timestamp":1785567537944,"version":"3.56.0"},"reference-count":33,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,7,31]],"date-time":"2026-07-31T00:00:00Z","timestamp":1785456000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,7,31]],"date-time":"2026-07-31T00:00:00Z","timestamp":1785456000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100003970","name":"Isfahan University of Medical Sciences","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100003970","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["analyticalsciencejournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J of Applied Toxicology"],"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>Pharmaceutical poisoning is a major health concern and a leading method of intentional self\u2010poisoning. In Iran, broad medication access has increased the burden, yet factors distinguishing intentional from accidental exposures remain underexplored. This study aimed to identify the determinants of intentional pharmaceutical poisoning using both traditional statistical methods and machine learning techniques. We conducted a cross\u2010sectional study at a referral poisoning center in Isfahan, Iran, between January 2015 and December 2019. Medical records of patients admitted with pharmaceutical poisoning were reviewed for demographics, toxicological characteristics, and past history. Univariate logistic regression assessed determinants of intentional poisoning. A multilayer perceptron (MLP) neural network evaluated variable importance and discrimination. Among 3096 eligible patients, 94.4% were intentional cases. Mean (SD) age of intentional cases was 32.14 (10.74) years, predominantly 20\u201340\u2009years. Logistic regression identified female sex (OR: 2.01; 95% CI: 1.47\u20132.73), age 20\u201340 (OR: 9.85; 95% CI: 6.79\u201314.29), age 41\u201360 (OR: 4.80; 95% CI: 2.94\u20137.85), and history of psychiatric disease (OR: 1.54; 95% CI: 1.03\u20132.30) as significant determinants. The MLP showed strong discrimination (AUC: 0.859); age, number of children, education, and history of psychiatric disease were top predictors. Efforts should prioritize family and social support, mitigation of educational\/occupational stressors, early psychiatric screening, timely psychological care, and community\u2010based programs to identify and protect high\u2010risk groups and reduce recurrence.<\/jats:p>","DOI":"10.1002\/jat.70378","type":"journal-article","created":{"date-parts":[[2026,8,1]],"date-time":"2026-08-01T06:36:13Z","timestamp":1785566173000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Determinants of Intentional Pharmaceutical Poisoning: A Cross\u2010Sectional Study From a Referral Poisoning Center in Iran"],"prefix":"10.1002","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9792-8160","authenticated-orcid":false,"given":"Nastaran","family":"Eizadi\u2010Mood","sequence":"first","affiliation":[{"name":"Department of Clinical Toxicology, Isfahan Clinical Toxicology Research Center, School of Medicine Isfahan University of Medical Sciences  Isfahan Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maryam","family":"Rajaeizadeh","sequence":"additional","affiliation":[{"name":"Department of Clinical Toxicology Isfahan University of Medical Sciences  Isfahan Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1930-0340","authenticated-orcid":false,"given":"Awat","family":"Feizi","sequence":"additional","affiliation":[{"name":"Department of Epidemiology &amp; Biostatistics, School of Health Isfahan University of Medical Sciences  Isfahan Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3271-0942","authenticated-orcid":false,"given":"Razieh","family":"Yazdi","sequence":"additional","affiliation":[{"name":"Department of Clinical Toxicology Isfahan University of Medical Sciences  Isfahan Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2556-4182","authenticated-orcid":false,"given":"Amin","family":"Dorostkar","sequence":"additional","affiliation":[{"name":"Department of Clinical Toxicology Isfahan University of Medical Sciences  Isfahan Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Parisa","family":"Mirmoghtadaee","sequence":"additional","affiliation":[{"name":"Deputy of Research and Technology Isfahan University of Medical Sciences  Isfahan Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6266-0595","authenticated-orcid":false,"given":"Rokhsareh","family":"Meamar","sequence":"additional","affiliation":[{"name":"Department of Clinical Toxicology, School of Medicine, Isfahan Clinical Toxicology Research Center Khorshid Hospital, Isfahan University of Medical Sciences  Isfahan Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,7,31]]},"reference":[{"issue":"1","key":"e_1_2_9_2_1","doi-asserted-by":"crossref","first-page":"233","DOI":"10.4103\/jfmpc.jfmpc_1184_21","article-title":"Deliberate Self\u2010Poisoning and Harm: A Meticulous Quest of Methods in Vogue","volume":"11","author":"Abhilash K. P. P.","year":"2022","journal-title":"Journal of Family Medicine and Primary Care"},{"issue":"4","key":"e_1_2_9_3_1","first-page":"327","article-title":"A Narrative Review of Acute Adult Poisoning in Iran","volume":"42","author":"Alinejad S.","year":"2017","journal-title":"Iranian Journal of Medical Sciences"},{"issue":"4","key":"e_1_2_9_4_1","doi-asserted-by":"crossref","first-page":"475","DOI":"10.4103\/JPBS.JPBS_340_19","article-title":"Pharmaceuticals Poisoning: Reported by the National Poison Centre in Malaysia Between 2010 and 2015","volume":"12","author":"Alwan I. A.","year":"2020","journal-title":"Journal of Pharmacy & Bioallied Sciences"},{"issue":"2","key":"e_1_2_9_5_1","doi-asserted-by":"crossref","first-page":"71","DOI":"10.18869\/acadpub.aums.1.2.71","article-title":"Epidemiological Study of Poisoning in Teaching Hospitals in Shiraz in 1387","volume":"1","author":"Aryaie M.","year":"2012","journal-title":"Alborz University Medical Journal"},{"issue":"2","key":"e_1_2_9_6_1","first-page":"97","article-title":"Self Poisoning With Suicidal Intent\u2014Part I [in Persian]","volume":"7","author":"Azin S. A.","year":"2008","journal-title":"Payesh (Health Monitor Journal)"},{"issue":"1","key":"e_1_2_9_7_1","doi-asserted-by":"crossref","first-page":"902","DOI":"10.1186\/s12889-016-3585-9","article-title":"Epidemiological Survey of Intentional Poisoning Suicide During 1993\u20132013 in Ilam Province, Iran","volume":"16","author":"Azizpour Y.","year":"1993","journal-title":"BMC Public Health"},{"issue":"6","key":"e_1_2_9_8_1","article-title":"Uncovering the Hidden Burden of Pharmaceutical Poisoning in High\u2010Income and Low\u2010Middle\u2010Income Countries: A Scoping Review","volume":"11","author":"Cowans C.","year":"2023","journal-title":"Pharmacy (Basel)"},{"issue":"3","key":"e_1_2_9_9_1","doi-asserted-by":"crossref","first-page":"206","DOI":"10.1111\/acps.13240","article-title":"Parenthood Is Associated With Lower Suicide Risk: A Register\u2010Based Cohort Study of 1.5 Million Swedes","volume":"143","author":"Dehara M.","year":"2021","journal-title":"Acta Psychiatrica Scandinavica"},{"key":"e_1_2_9_10_1","doi-asserted-by":"crossref","DOI":"10.1016\/j.jflm.2026.103155","article-title":"Evaluation of Factors Associated With Intentional Non\u2010Pharmaceutical Poisoning in Iran","volume":"111","author":"Eizadi\u2010Mood N.","year":"2026","journal-title":"Journal of Forensic and Legal Medicine"},{"issue":"1","key":"e_1_2_9_11_1","doi-asserted-by":"crossref","DOI":"10.1038\/s41598-024-61411-w","article-title":"Clinico\u2010Epidemiological Evaluation of Pharmaceutical\/Non\u2010Pharmaceutical Poisoning in a Referral Poisoning Emergency in the Central Part of Iran","volume":"14","author":"Eizadi\u2010Mood N.","year":"2024","journal-title":"Scientific Reports"},{"issue":"1","key":"e_1_2_9_12_1","doi-asserted-by":"crossref","first-page":"23","DOI":"10.1017\/S003329179900135X","article-title":"Risk Factors and Life Processes Associated With the Onset of Suicidal Behaviour During Adolescence and Early Adulthood","volume":"30","author":"Fergusson D. M.","year":"2000","journal-title":"Psychological Medicine"},{"issue":"6","key":"e_1_2_9_13_1","doi-asserted-by":"crossref","first-page":"570","DOI":"10.1001\/jamapsychiatry.2014.3188","article-title":"Risk of Suicide Following Deliberate Self\u2010Poisoning","volume":"72","author":"Finkelstein Y.","year":"2015","journal-title":"JAMA Psychiatry"},{"key":"e_1_2_9_14_1","doi-asserted-by":"crossref","first-page":"41","DOI":"10.2147\/DHPS.S241413","article-title":"A Retrospective Study of Acute Poisoning Cases and Their Management at Emergency Department of Dessie Referral Hospital, Northeast Ethiopia","volume":"12","author":"Getie A.","year":"2020","journal-title":"Drug, Healthcare and Patient Safety"},{"issue":"5","key":"e_1_2_9_15_1","first-page":"449","article-title":"A Prospective Study of Fatal Outcomes of Poisoning in Tehran","volume":"37","author":"Ghazi\u2010Khansari M.","year":"1995","journal-title":"Veterinary and Human Toxicology"},{"issue":"3","key":"e_1_2_9_16_1","doi-asserted-by":"crossref","first-page":"235","DOI":"10.1071\/HC20017","article-title":"Prescribers Aware: A Cross\u2010Sectional Study From New Zealand Emergency Departments on the Substances Used in Intentional Self\u2010Poisoning and Their Sources","volume":"12","author":"Kumpula E.\u2010K.","year":"2020","journal-title":"Journal of Primary Health Care"},{"issue":"1","key":"e_1_2_9_17_1","doi-asserted-by":"crossref","first-page":"157","DOI":"10.1186\/s12877-024-04717-8","article-title":"Repeated Hospital Admission for Intentional Poisonings Among Older Adults\u2014A Swedish National Register\u2010Based Study","volume":"24","author":"Laflamme L.","year":"2024","journal-title":"BMC Geriatrics"},{"issue":"1","key":"e_1_2_9_18_1","doi-asserted-by":"crossref","first-page":"16","DOI":"10.1186\/s12991-022-00393-3","article-title":"Socio\u2010Demographic and Psychiatric Profile of Patients Hospitalized due to Self\u2010Poisoning With Suicidal Intention","volume":"21","author":"Lumpe M.","year":"2022","journal-title":"Annals of General Psychiatry"},{"key":"e_1_2_9_19_1","doi-asserted-by":"crossref","first-page":"242","DOI":"10.1016\/j.jpsychires.2021.02.053","article-title":"Estimating the Risk of Suicide Associated With Mental Disorders: A Systematic Review and Meta\u2010Regression Analysis","volume":"137","author":"Moitra M.","year":"2021","journal-title":"Journal of Psychiatric Research"},{"issue":"5","key":"e_1_2_9_20_1","doi-asserted-by":"crossref","first-page":"729","DOI":"10.1016\/j.socscimed.2011.06.021","article-title":"Unfulfilled Expectations and Symptoms of Depression Among Young Adults","volume":"73","author":"Mossakowski K. N.","year":"2011","journal-title":"Social Science & Medicine"},{"issue":"2","key":"e_1_2_9_21_1","first-page":"79","article-title":"One\u2010Year Study on Pattern of Acute Pharmaceutical and Chemical Poisoning Cases Admitted to a Tertiary Care Hospital in Thrissur, India","volume":"4","author":"Nair P. K.","year":"2015","journal-title":"Asia Pacific Journal of Medical Toxicology"},{"issue":"1","key":"e_1_2_9_22_1","doi-asserted-by":"crossref","first-page":"1312","DOI":"10.1038\/s41598-023-28353-1","article-title":"Pharmaceutical Toxicity Is a Common Pattern of Inpatient Acute Poisonings in Birjand City, East of Iran","volume":"13","author":"Naseri K.","year":"2023","journal-title":"Scientific Reports"},{"issue":"5","key":"e_1_2_9_23_1","doi-asserted-by":"crossref","first-page":"470","DOI":"10.1192\/bjp.187.5.470","article-title":"Mortality and Suicide After Non\u2010Fatal Self\u2010Poisoning: 16\u2010Year Outcome Study","volume":"187","author":"Owens D.","year":"2005","journal-title":"British Journal of Psychiatry: The Journal of Mental Science"},{"issue":"12","key":"e_1_2_9_24_1","doi-asserted-by":"crossref","first-page":"1328","DOI":"10.1177\/0960327116630353","article-title":"Intentional Poisoning Among Elderly People\u2014Residents of a Large Urban Agglomeration in Poland","volume":"35","author":"Piekarska\u2010Wijatkowska A.","year":"2016","journal-title":"Human & Experimental Toxicology"},{"issue":"1","key":"e_1_2_9_25_1","doi-asserted-by":"crossref","DOI":"10.1080\/20523211.2024.2325513","article-title":"Epidemiology, Clinical Characteristics, and Associated Cost of Acute Poisoning: A Retrospective Study","volume":"17","author":"Salem W.","year":"2024","journal-title":"Journal of Pharmaceutical Policy and Practice"},{"key":"e_1_2_9_26_1","doi-asserted-by":"crossref","first-page":"302","DOI":"10.1016\/j.jad.2019.08.054","article-title":"The Association Between Mental Disorders and Suicide: A Systematic Review and Meta\u2010Analysis of Record Linkage Studies","volume":"259","author":"San Too L.","year":"2019","journal-title":"Journal of Affective Disorders"},{"issue":"11","key":"e_1_2_9_27_1","doi-asserted-by":"crossref","first-page":"2241","DOI":"10.1007\/s00127-022-02321-y","article-title":"Parenthood and Lower Risk of Suicide in Women and Men: The Total Swedish Population Followed Across Adulthood","volume":"57","author":"S\u00f6rberg Wallin A.","year":"2022","journal-title":"Social Psychiatry and Psychiatric Epidemiology"},{"issue":"8","key":"e_1_2_9_28_1","doi-asserted-by":"crossref","DOI":"10.1016\/j.heliyon.2024.e29741","article-title":"Mortality of Acute Poisoning and Its Predictors in Ethiopia: A Systematic Review and Meta\u2010Analysis","volume":"10","author":"Telayneh A. 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