Academic journal article Indian Journal of Psychiatry

Revisiting Profile of Deliberate Self-Harm at a Tertiary Care Hospital after an Interval of 10 Years

Academic journal article Indian Journal of Psychiatry

Revisiting Profile of Deliberate Self-Harm at a Tertiary Care Hospital after an Interval of 10 Years

Article excerpt

Byline: Paramjeet. Singh, Raghav. Shah, Purav. Midha, Ajitabh. Soni, Sunil. Bagotia, Kusum. Gaur

Context: Sociocultural factors complement psychopathological factors that result in deliberate self-harm (DSH). A study of change in these factors over time is essential for preventive action. Aims: To identify factors influencing DSH, which have shown significant variation over a period of 10 years. Settings and Design: Two hospital-based cross-sectional analytic types of observational studies were performed at two different times at an interval of 10 years. Materials and Methods: Sociodemographic profile, factors related to DSH, stressful life events, and psychiatric disorders were assessed in two groups of patients drawn from the same tertiary care hospital, 100 consecutive patients in 2002 and 117 in 2012. The observations were compared to identify factors that have undergone significant change. Statistical Analysis: Descriptive statistics along with Chi-square test was used in this study. Results: A significant decrease in the overall number of married subjects (60% vs. 43%) and an increase in the number of unmarried females (34% vs. 61%) were seen. A significant increase in the overall number of rural subjects (17% vs. 34%) and especially in a number of rural females (7% vs. 23%) was also seen. An increase in subjects from middle socioeconomic class (15% vs. 29%) and education up to secondary school (9% vs. 25%) was also seen. A significantly higher number of subjects had a psychiatric disorder (50% vs. 81%) with a significant increase in diagnoses of depression (36% vs. 67%). Family and social issues remain the most common antecedent stressful events. Chemical methods are still the most preferred means, but a higher number (8% vs. 18%) report a history of self-harm. Conclusion: Variations in factors responsible for DSH identified in this comparative study have preventive implications.

Introduction

In India, about 100,000 persons commit suicide every year, contributing to about 10% of the suicides in the world.[sup][1] The National Crime Records Bureau statistics report that the number of suicides in the country during the decade (2002–2012) have recorded an increase of 22.7% (135,445 in 2012 from 110,417 in 2002).[sup][2] The national suicide rate for 2012 was 11.2 per 100,000 population [sup][2]. Suicide is among the top ten causes of death in India and among the top three causes of death in those who are between 16 and 25 years of age.[sup][2] It is estimated that the incidence of nonfatal deliberate self-harm (DSH) is 250 per 100,000 persons per year.[sup][3] Thus, in recent years attempted suicide has become the focus of research as it has been found to be one of the significant predictors of suicide.[sup][4],[5] Indian research has shown that there are considerable age- and gender-related differences in psychosocial and psychiatric factors among individuals who attempt suicide.[sup][6],[7],[8],[9],[10] A review of the Indian research on suicide reveals that there is a relative paucity of publications on attempted suicide and in addition to mental illnesses; societal structures and specific stressors play a prominent role.[sup][11] Cultural epidemiological research that takes into account the underlying problems, their perceived causes, triggers of suicidal behaviors along with locally relevant patterns of suicidal behavior in addition to the customary psychopathological account is important in preventive action planning.[sup][12] In the current study, a comparison of sociocultural and psychiatric factors between two samples of DSH participants drawn from the same population over a gap of 10 years is done. The understanding of variations that have occurred in these risk factors over a period can help in better understanding and prevention of these risk factors.

Materials and Methods

Two hospital-based cross-sectional observational studies were carried out at an interval of 10 years in 2002 (Study 1) with 100 participants and 2012 (Study 2) with 117 patients, respectively, by the Department of Psychiatry, SMS Medical College, Jaipur. …

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