Deliberate self-harm at RK Khan hospital internal medicine department: the influence of age on the likelihood of admission, triggers, methods used and outcomes.

Abstract

A prior suicide attempt is the most important risk factor for complete suicide. For every completed suicide it is estimated that more than 20 suicide attempts are made. From July to December 2016, Deliberate Self-Harm (DSH) was the top admission diagnosis in RK Khan Hospital Internal Medicine Department. We investigated the incidence and demographic patterns of DSH in this department. In addition, the influence of age on the likelihood of admission, triggers, methods used and outcomes was explored. The method used was a retrospect chart review for the period January 2017 to June 2017 of all patients admitted with DSH. Data analysis of continuous variables was summarized as medians for highly skewed variables. Categorical data were summarized using portions and percentages. Proportions were compared using PEARSON’S CHI SQUARE test and FISHER EXACT test as appropriate. A total of 226 patients were included in the study. The incidence of DSH in the study period was 5.12% of total admissions, a reduction from the 9.16% that it represented in the 6 months prior to the study. There was a higher proportion of females admitted compared to the total admissions. The median age was 26 years, with the median age of females being 7 years younger than that of males. There was a higher proportion of adolescent patients admitted with DSH versus the total admissions than other age groups. 18.1% of the study patients reported a previous history of self-harm. Alcohol was involved in 10.6% of cases. The commonest method used was drug overdose, analgesia being the most common agent. The most frequent triggers were that of domestic dispute and romantic/marital relationship problems. There was a low mortality rate of 1.77% and patients stayed on average for 3.05 days. Age and gender were not dependant factors in the outcomes of patients that presented with DSH. Interpretation of age and gender associations with means of DSH, may point to the easy accessibility of drugs playing the decisive role in the choice of method used. The triggers used need to be further explored using qualitative methods for better understanding of their association with age.