Deliberate Self-harm: Characteristics of Patients Presenting to a Tertiary Care Hospital in Karachi, Pakistan

Introduction: Previous deliberate self-harm (DSH) is the strongest predictor of suicide. Although several studies exist in other countries, characteristics of DSH have not been well-studied in Pakistan.

Aims: To identify characteristics of deliberate self-harm in a hospital population, building on previous work carried out on this subject at this center.

Methods: 284 cases admitted to the Aga Khan University Hospital, Karachi, between January 1997 and August 2003 were studied by analyzing medical records. Information was collected regarding demographics, family history, personal history, suicidal ideation, current stressors, the act of DSH and its management.

Results: The most common age group was 21-25 years of age. The majority were females (60.3%). 95.1% of patients used self-poisoning as a method of deliberate self-harm. 47.3% used benzodiazepines for self-poisoning. Precipitating factors included conflict with family, marital problems, chronic illnesses, and unemployment. Comorbid psychiatric disorders were present in 76.4% patients.

Discussion: Despite the difference in socio-cultural background of our patients, many of our results were found to be consistent with Western data. Our findings suggest that problem-solving therapy, stress management and improved mental health care may be effective interventions in preventing DSH. Prescription of medications should be regulated. Further studies are suggested at the community level.