Psychiatric Comorbidities in Patients with Deliberate Self-Harm in a Tertiary Care Center

Abstract

Introduction: Deliberate self-harm is one of the common psychiatric emergencies in medical practice. It has become a global health problem with rates increasing over time. This hospital based study may help in understanding the cause, methods and psychiatric comorbidities present in such patients. The aim of this study was to (i) study the relationship between major socio-demographic variables and deliberate self-harm (ii) evaluate methods and precipitating cause (iii) determine the nature and prevalence of psychiatric and personality disorders in deliberate-self harm patients.Methods: This retrospective observational study was performed on 200 cases of deliberate self-harm in a tertiary referral centre in Eastern Nepal by the data collected from the medical records of these patients. Various sociodemographic data and psychiatric comorbidities prevalent in them were analysed.Results: Majority of the suicide attempters (77%) were less than 35 years of age. The female-to-male ratio was 1.35:1. 76% of the patients had received formal education. Majority (73.5%) were married. By occupation, 38% were housewives and 25.5% were students. 72.5% of cases had consumed organophosphates/-chlorides. Interpersonal conflict (72%) was the major cause of DSH. ICD-10 psychiatric disorders were diagnosed in 37% of cases and premorbid personality problems were present in 20% of cases. The most common diagnosis was adjustment disorder (13.5%) followed by mood disorder (11%).Conclusions: Majority of DSH cases were of younger generation. Psychiatric disorders and comorbid personality problems are common in DSH patients. This has important implications for proper assessment and management.Keywords: Deliberate self-harm; Organophosphorous; Para suicide; Psychiatric co-morbidities.