Mortality Patterns and Trends in Fars Province, Iran (2015-2024): A Retrospective Analysis of Death Records.

Clinical (Medical) toxicology is a dynamic and ever-changing field that focuses on drug overdoses, poisonings, adverse drug effects, and substance use disorders, including addiction and withdrawal. Additionally, in cases of intentional toxic events, it becomes closely intertwined with societal factors and psychiatric comorbidities. This paper introduced a novel concept for expanding medical education in Iran. Its publication aimed to draw attention to significant aspects, yet overlooked, gaps in medical education that have been addressed in other countries for years. Various cases of acute poisoning are referred to our hospital, often associated with mental health conditions or suicide attempts. These include patients under psychiatric care for mental illness and substance abuse, as well as first-time attempters who exhibit psychiatric disorders. A critical gap becomes evident in patient disposition, as the majority of recovered cases decline inpatient mental evaluation and urge toxicologists for early discharge. Understanding toxicological mechanisms can deepen residents’ insight into psychotropic drug safety, adverse drug effects, and drug interactions—critical components of psychiatric pharmacotherapy. Despite these clinical realities, formal medical toxicology training remains limited in most psychiatric curricula. In Iran, suicide attempts constitute a significant public health burden, with intentional poisoning as the predominant method. Hajebi and colleagues, in a study covering 83.6% of Iran’s population in 2009, found self-poisoning to be the most common method for both suicide attempts (90.4%) and completed suicides (38.3%). A five-year population-based survey in Northwestern Iran (2017–2021) analyzed 3,456 suicide attempts, revealing that poisoning with medications accounted for 87.3% of cases, far surpassing other methods such as cutting (8.2%) or hanging (2.1%). The incidence rate escalated dramatically from 99.49 to 247.41 per 100,000 population during this period, underscoring an alarming trend. Women comprised 68.5% of attempters, and only 2.8% had prior attempts, indicating many first-time crises requiring prompt psychiatric intervention. In a one-year study of poisoning cases at Loghman Hakim Hospital, Vatandoost and colleagues reported that 93.7% (18,282 of 19,511) of poisoning cases were intentional.