Clinical Profile and Risk Factors of Deliberate Self-Harm Among Patients Presenting to a Tertiary Care Hospital in Bangladesh

Open Access

Abstract

Introduction: Deliberate self-harm is a major public health concern and an important cause of emergency hospital admission, particularly among young adults. It is influenced by a complex interaction of psychiatric disorders, substance use, and psychosocial stressors such as family conflict, relationship problems, and financial difficulties. Therefore, the present study aims to assess the clinical characteristics and associated risk factors of deliberate self-harm among patients presenting to a tertiary care hospital in Bangladesh. Methods & Materials: This observational descriptive cross-sectional study was conducted in Department of Psychiatry, Combined Military Hospital, Dhaka, Bangladesh, from January 2023 to December 2023 among patients presenting with deliberate self-harm. A total of 120 consecutive eligible patients were enrolled by purposive sampling. Data were analyzed using SPSS version 26.0. Result: In this study, most were young adults aged 20-29 years (46.7%) and females (60.8%). Pesticide poisoning (39.2%) and drug overdose (31.7%) were the leading methods, while vomiting (59.2%) and altered consciousness (28.3%) were common clinical features. Nearly half of the patients presented within 2-6 hours, and 19.2% required ICU admission. The major risk factors identified were psychosocial stressors (74.2%), psychiatric illness (35.0%), and substance use (30.0%), with family conflict being the most frequent psychosocial factor. Previous deliberate self-harm was significantly associated with younger age, psychiatric morbidity, substance use, and the presence of psychosocial stressors. Conclusion: Deliberate self-harm among patients presenting to this tertiary care hospital was observed mainly in young adults, with a higher occurrence among females, and pesticide ingestion and drug overdose were the leading methods employed. Psychosocial difficulties were common, and a considerable percentage of patients had underlain psychiatric disorders and a history of substance use. Younger age, psychiatric comorbidity, substance use, and exposure to psychosocial stressors were significantly associated with a history of previous deliberate self-harm.