{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,16]],"date-time":"2026-09-16T00:19:19Z","timestamp":1789517959308,"version":"build-2803163510"},"reference-count":40,"publisher":"BMJ","issue":"2","funder":[{"DOI":"10.13039\/501100000925","name":"National Health and Medical Research Council","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100000925","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2018,12,12]]},"published-print":{"date-parts":[[2019,2]]},"abstract":"<jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>To characterise trends in self-poisoning and psychotropic medicine use in young Australians.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>Population-based retrospective cohort study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>Calls taken by the New South Wales and Victorian Poisons Information Centres (2006\u20132016, accounting for 70% of Australian poisoning calls); medicine dispensings in the 10% sample of Australian Pharmaceutical Benefits Scheme data (July 2012 to June 2016).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Participants<\/jats:title>\n                    <jats:p>People aged 5\u201319 years.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Main outcome measures<\/jats:title>\n                    <jats:p>Yearly trends in intentional poisoning exposure calls, substances taken in intentional poisonings, a prevalence of psychotropic use (dispensing of antidepressants, antipsychotics, benzodiazepines and medicines for attention deficit hyperactivity disorder (ADHD)).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>There were 33\u2009501 intentional poisonings in people aged 5\u201319 years, with an increase of 8.39% per year (95%\u2009CI 6.08% to 10.74%, p&lt;0.0001), with a 98% increase overall, 2006\u20132016. This effect was driven by increased poisonings in those born after 1997, suggesting a birth cohort effect. Females outnumbered males 3:1. Substances most commonly taken in self-poisonings were paracetamol, ibuprofen, fluoxetine, ethanol, quetiapine, paracetamol\/opioid combinations, sertraline and escitalopram. Psychotropic dispensing also increased, with selective serotonin reuptake inhibitors (SSRIs) increasing 40% and 35% July 2012 to June 2016 in those aged 5\u201314 and 15\u201319, respectively. Fluoxetine was the most dispensed SSRI. Antipsychotics increased by 13% and 10%, while ADHD medication dispensing increased by 16% and 10%, in those aged 5\u201314 and 15\u201319, respectively. Conversely, dispensing of benzodiazepines to these age groups decreased by 4% and 5%, respectively.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Our results signal a generation that is increasingly engaging in self-harm and is increasingly prescribed psychotropic medications. These findings indicate growing mental distress in this cohort. Since people who self-harm are at increased risk of suicide later in life, these results may foretell future increases in suicide rates in Australia.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2018-026001","type":"journal-article","created":{"date-parts":[[2019,2,20]],"date-time":"2019-02-20T13:28:19Z","timestamp":1550669299000},"page":"e026001","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":66,"title":["Trends in self-poisoning and psychotropic drug use in people aged 5\u201319 years: a population-based retrospective cohort study in Australia"],"prefix":"10.1136","volume":"9","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8946-5079","authenticated-orcid":false,"given":"Rose","family":"Cairns","sequence":"first","affiliation":[{"name":"NSW Poisons Information Centre, The Children\u2019s Hospital at Westmead, Sydney, New South Wales, Australia"},{"name":"Sydney Pharmacy School, The University of Sydney, Sydney, New South Wales, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emily A","family":"Karanges","sequence":"additional","affiliation":[{"name":"Centre for Big Data Research in Health, University of New South Wales, Sydney, New South Wales, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anselm","family":"Wong","sequence":"additional","affiliation":[{"name":"Victorian Poisons Information Centre and Austin Toxicology Service, Austin Health, Heidelberg, Victoria, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jared A","family":"Brown","sequence":"additional","affiliation":[{"name":"NSW Poisons Information Centre, The Children\u2019s Hospital at Westmead, Sydney, New South Wales, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeff","family":"Robinson","sequence":"additional","affiliation":[{"name":"Victorian Poisons Information Centre, Austin Health, Heidelberg, Victoria, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sallie-Anne","family":"Pearson","sequence":"additional","affiliation":[{"name":"Centre for Big Data Research in Health, University of New South Wales, Sydney, New South Wales, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew H","family":"Dawson","sequence":"additional","affiliation":[{"name":"NSW Poisons Information Centre, The Children\u2019s Hospital at Westmead, Sydney, New South Wales, Australia"},{"name":"Central Clinical School, The University of Sydney, Sydney, New South Wales, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicholas A","family":"Buckley","sequence":"additional","affiliation":[{"name":"NSW Poisons Information Centre, The Children\u2019s Hospital at Westmead, Sydney, New South Wales, Australia"},{"name":"Pharmacology, University of Sydney, Sydney, New South Wales, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2019,2,20]]},"reference":[{"key":"2025121222553447000_9.2.e026001.1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(12)60322-5"},{"key":"2025121222553447000_9.2.e026001.2","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0129062","article-title":"What are reasons for the large gender differences in the lethality of suicidal acts? An epidemiological analysis in four european countries","volume":"10","author":"Mergl","year":"2015","journal-title":"PLoS One"},{"key":"2025121222553447000_9.2.e026001.3","doi-asserted-by":"crossref","first-page":"532","DOI":"10.1016\/S2215-0366(15)00170-4","article-title":"Long-term outcomes following self-poisoning in adolescents: a population-based cohort study","volume":"2","author":"Finkelstein","year":"2015","journal-title":"Lancet Psychiatry"},{"key":"2025121222553447000_9.2.e026001.4","unstructured":"World Health Organization. Adolescent health epidemiology [Internet]. 2017 http:\/\/www.who.int\/maternal_child_adolescent\/epidemiology\/adolescence\/en\/ (cited 5 Jul 2017)."},{"key":"2025121222553447000_9.2.e026001.5","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2014-3573"},{"key":"2025121222553447000_9.2.e026001.6","first-page":"698","article-title":"Increased hospitalizations and ICU admissions in poison center cases involving teenagers","volume":"54","author":"Bottei","year":"2016","journal-title":"Clin Toxicol"},{"key":"2025121222553447000_9.2.e026001.7","doi-asserted-by":"publisher","DOI":"10.1136\/injuryprev-2015-041901"},{"key":"2025121222553447000_9.2.e026001.8","doi-asserted-by":"crossref","first-page":"348","DOI":"10.5694\/mja17.00589","article-title":"Presentations to NSW emergency departments with self-harm, suicidal ideation, or intentional poisoning, 2010-2014","volume":"208","author":"Perera","year":"2018","journal-title":"Med J Aust"},{"key":"2025121222553447000_9.2.e026001.9","doi-asserted-by":"crossref","first-page":"343","DOI":"10.5694\/mja17.00434","article-title":"Paediatric mental and physical health presentations to emergency departments, Victoria, 2008-15","volume":"208","author":"Hiscock","year":"2018","journal-title":"Med J Aust"},{"key":"2025121222553447000_9.2.e026001.10","unstructured":"Medco. America\u2019s state of mind [Internet]. 2011:1\u201311 http:\/\/www.jstor.org\/stable\/ (cited 17 Oct 2016)."},{"key":"2025121222553447000_9.2.e026001.11","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0033181","article-title":"Trends in depression and antidepressant prescribing in children and adolescents: a cohort study in The Health Improvement Network (THIN)","volume":"7","author":"Wijlaars","year":"2012","journal-title":"PLoS One"},{"key":"2025121222553447000_9.2.e026001.12","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2007-2008"},{"key":"2025121222553447000_9.2.e026001.13","doi-asserted-by":"publisher","DOI":"10.1177\/0004867414538675"},{"key":"2025121222553447000_9.2.e026001.14","doi-asserted-by":"crossref","first-page":"438","DOI":"10.5694\/mja14.01116","article-title":"A prospective cohort study of trends in self-poisoning, Newcastle, Australia, 1987-2012: plus \u00e7a change, plus c\u2019est la m\u00eame chose","volume":"202","author":"Buckley","year":"2015","journal-title":"Med J Aust"},{"key":"2025121222553447000_9.2.e026001.15","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpsychores.2015.01.006"},{"key":"2025121222553447000_9.2.e026001.16","doi-asserted-by":"publisher","DOI":"10.2165\/00023210-200721060-00003"},{"key":"2025121222553447000_9.2.e026001.17","doi-asserted-by":"crossref","first-page":"881","DOI":"10.1016\/S0140-6736(16)30385-3","article-title":"Comparative efficacy and tolerability of antidepressants for major depressive disorder in children and adolescents: a network meta-analysis","volume":"388","author":"Cipriani","year":"2016","journal-title":"Lancet"},{"key":"2025121222553447000_9.2.e026001.18","doi-asserted-by":"crossref","first-page":"634","DOI":"10.1186\/s13104-015-1616-8","article-title":"The Australian Pharmaceutical Benefits Scheme data collection: a practical guide for researchers","volume":"8","author":"Mellish","year":"2015","journal-title":"BMC Res Notes"},{"key":"2025121222553447000_9.2.e026001.19","doi-asserted-by":"publisher","DOI":"10.1192\/bjp.182.2.164"},{"key":"2025121222553447000_9.2.e026001.20","first-page":"4","article-title":"Can SNOMED CT as implemented in New South Wales, Australia be used for road trauma injury surveillance in emergency departments?","volume":"42","author":"Mitchell","year":"2013","journal-title":"Health Inf Manag"},{"key":"2025121222553447000_9.2.e026001.21","doi-asserted-by":"crossref","first-page":"1848","DOI":"10.1111\/add.13450","article-title":"The impact of codeine re-scheduling on misuse: a retrospective review of calls to Australia\u2019s largest poisons centre","volume":"111","author":"Cairns","year":"2016","journal-title":"Addiction"},{"key":"2025121222553447000_9.2.e026001.22","doi-asserted-by":"publisher","DOI":"10.1111\/bcp.12937"},{"key":"2025121222553447000_9.2.e026001.23","doi-asserted-by":"crossref","first-page":"S136","DOI":"10.1016\/j.eurpsy.2015.09.266","article-title":"Trends in self-poisoning in children and adolescents in Southern Brazil between 2005 and 2013","volume":"30","author":"Rheinheimer","year":"2015","journal-title":"European Psychiatry"},{"key":"2025121222553447000_9.2.e026001.24","doi-asserted-by":"crossref","first-page":"573","DOI":"10.1001\/jamapediatrics.2017.0250","article-title":"Child and Adolescent Health From 1990 to 2015","volume":"171","author":"Kassebaum","year":"2017","journal-title":"JAMA Pediatr"},{"key":"2025121222553447000_9.2.e026001.25","doi-asserted-by":"publisher","DOI":"10.1177\/070674371205700109"},{"key":"2025121222553447000_9.2.e026001.26","doi-asserted-by":"publisher","DOI":"10.1111\/acps.12155"},{"key":"2025121222553447000_9.2.e026001.27","doi-asserted-by":"crossref","first-page":"635","DOI":"10.1007\/s00787-014-0631-y","article-title":"Recent international trends in psychotropic medication prescriptions for children and adolescents","volume":"24","author":"Steinhausen","year":"2015","journal-title":"Eur Child Adolesc Psychiatry"},{"key":"2025121222553447000_9.2.e026001.28","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0089944","article-title":"Hospital presenting self-harm and risk of fatal and non-fatal repetition: systematic review and meta-analysis","volume":"9","author":"Carroll","year":"2014","journal-title":"PLoS One"},{"key":"2025121222553447000_9.2.e026001.29","doi-asserted-by":"crossref","first-page":"751","DOI":"10.1016\/S2215-0366(16)30094-3","article-title":"Suicide in children and young people in England: a consecutive case series","volume":"3","author":"Rodway","year":"2016","journal-title":"Lancet Psychiatry"},{"key":"2025121222553447000_9.2.e026001.30","unstructured":"Australian Communications and Media Authority. Aussie teens and kids online: Research snapshot [Internet]. 2016 https:\/\/www.acma.gov.au\/theACMA\/engage-blogs\/engage-blogs\/Research-snapshots\/Aussie-teens-and-kids-online."},{"key":"2025121222553447000_9.2.e026001.31","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0077555","article-title":"The power of the web: a systematic review of studies of the influence of the internet on self-harm and suicide in young people","volume":"8","author":"Daine","year":"2013","journal-title":"PLoS One"},{"key":"2025121222553447000_9.2.e026001.32","doi-asserted-by":"publisher","DOI":"10.1111\/bcp.12040"},{"key":"2025121222553447000_9.2.e026001.33","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2125.2009.03382.x"},{"key":"2025121222553447000_9.2.e026001.34","doi-asserted-by":"publisher","DOI":"10.1097\/YIC.0b013e32832bb078"},{"key":"2025121222553447000_9.2.e026001.35","doi-asserted-by":"crossref","first-page":"74","DOI":"10.5694\/mja17.01063","article-title":"Patterns of poisoning exposure at different ages: the 2015 annual report of the Australian Poisons Information Centres","volume":"209","author":"Huynh","year":"2018","journal-title":"Med J Aust"},{"key":"2025121222553447000_9.2.e026001.36","doi-asserted-by":"publisher","DOI":"10.1002\/hep.20948"},{"key":"2025121222553447000_9.2.e026001.37","doi-asserted-by":"publisher","DOI":"10.1192\/bjp.168.1.43"},{"key":"2025121222553447000_9.2.e026001.38","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.38253.572581.7C"},{"key":"2025121222553447000_9.2.e026001.39","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.322.7296.1203"},{"key":"2025121222553447000_9.2.e026001.40","doi-asserted-by":"publisher","DOI":"10.1055\/s-2003-42640"}],"container-title":["BMJ Open"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bmjopen-2018-026001","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,12,13]],"date-time":"2025-12-13T06:55:47Z","timestamp":1765608947000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmjopen.bmj.com\/lookup\/doi\/10.1136\/bmjopen-2018-026001"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,2]]},"references-count":40,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2019,2,20]]},"published-print":{"date-parts":[[2019,2]]}},"alternative-id":["10.1136\/bmjopen-2018-026001"],"URL":"https:\/\/doi.org\/10.1136\/bmjopen-2018-026001","relation":{},"ISSN":["2044-6055","2044-6055"],"issn-type":[{"value":"2044-6055","type":"print"},{"value":"2044-6055","type":"electronic"}],"subject":[],"published":{"date-parts":[[2019,2]]}}}