Psychiatric manifestations of patients admitted for intentional self harm

Abstract

Introduction: Psychiatric illnesses are the most common risk factors for suicide. Most cases attempting suicide (Intentional self harm, ISH) present to the hospital emergency for medical complications arising as a result of self-harm forming an important group to understand the psychosocial profile. This study was undertaken to document the various psychiatric manifestations in the patients admitted for intentional self harm (ISH) in a tertiary care hospital.

Methods: A cross-sectional study was conducted in a tertiary hospital setting. The study population included all those patients who were admitted and being managed for ISH and brought for psychiatric evaluation during the period of six months (16thApril- 15th October 2010) at Dhulikhel Hospital. Each patient underwent a detailed psychiatric evaluation by a consultant psychiatrist once they were medically stable. Psychiatric diagnoses were considered as per ICD-10 criteria.

Results: Among the total subjects (N=73) evaluated during the six months period of the study, 43.8% were in the age group of 21-40 years {mean=30.26(±14.7)}, 69.9% were females (Female to Male ratio=2.31), 80.8% were married and 28.8% belonged to the Mongolian race. There were a steadily increasing number of the patients from April to August, peaking in the month of August. Poisoning was the commonest mode of ISH (93.2 %), Organophosphorus was the most common (72%) poison used. Maximum subjects (41.1%) were found to have Depression Spectrum Disorder (Depression, Dysthymia, Adjustment Disorder) followed by Personality Disorder (26%).

Conclusions: Patients attempting ISH are brought to tertiary care hospital for associated medical complications. Organophosphorus poisoning was the commonest mode of suicide while Depression spectrum disorder was the most common psychiatric diagnosis related to suicide. Most suicide cases were seen in the summer months.