Mercury among the means of suicidal actions

Intentional suicidal poisoning with elemental mercury is quite rare. This largely determines the complexity of assessing and describing the characteristics that are most important from a suicidological point of view, which limits the possibility of developing and implementing differentiated prevention measures. This review summarizes the data on 62 cases of suicidal actions using metallic mercury. It was shown that the predominance (66.1%) of attempts by the intravenous administration of metal and ingestion (19.4%), less often it was administered subcutaneously (11.3%). These methods are low toxic and rarely end in death. Inhalation of vapors occurs in isolated cases (3.2%) but manifests itself in significant damage. Household thermometers are the leading source of mercury. Among suicide attempters, men predominate (with the M : F ratio of 2.5 : 1) and young people (mean age of 31.8 years) with a low level of education and social status. Motives are mainly determined by depressive experiences, including those formed in the framework of psychotic disorders. Acute suicidal reactions are more often realized through ingestion or parenteral administration. The inhalation method is typical for long-term emotional disorders. Significant risk factors include alcohol and/or drug use. The diagnosis of poisoning is difficult due to the rarity of cases, the nonspecificity of most symptoms of toxic damage and the lack of personal clinical experience of working with such patients in most medical workers. Help for suicide attempters includes psychological support, correction of mental disorders. In order to reduce the toxic effect of mercury, chelation therapy is advised, with subcutaneous administration surgical removal is recommended. Prevention is poorly developed. The training of primary care physicians on mercury toxicology and suicidal prevention is relevant. In conclusion, the authors point out the need for further deeper research.