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To the Editor: The terrorist attacks in the United States on September 11, 2001, caused significant medical and psychiatric morbidity, particularly in Manhattan, and acutely disrupted the lives of people around the world.¹ However, little research has examined the effects of September 11 outside the United States. We hypothesized that the attacks influenced rates of deliberate self-harm, a complex behavioral phenomenon that includes deliberate self-poisoning. We conducted an ecological analysis of poisonings in the days immediately following September 11 in a population geographically removed from the events.

Methods

We identified all hospitalizations for self-poisoning in Ontario during the month of September from 1988 to 2003 using the population-based records of the Canadian Institutes of Health Information (International Classification of Diseases, Ninth Revision codes 960.0-990.0 and International Statistical Classification of Diseases, 10th Revision codes T36-T50.) To exclude instances of accidental toxicity, we restricted the analysis to poisonings in which the external . . . [Full Text of this Article]

Michael E. Detsky, BSc
Department of Medicine
University of Toronto
Toronto, Ontario

Marco L. A. Sivilotti, MD, MSc
Department of Pharmacology and Toxicology
Queen’s University
Kingston, Ontario

Alexander Kopp, BA; Peter C. Austin, PhD
Institute for Clinical Evaluative Sciences
Toronto, Ontario

David N. Juurlink, MD, PhD
dnj@ices.on.ca
Sunnybrook and Women’s College Health Sciences Centre
University of Toronto

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