Deliberate Self-Harm and Psychiatric Morbidities in an Egyptian Sample: Cross-sectional, Case-control Study

Dalia Hegazy Ali*, Mohamoud Fa

Abstract

Background: Deliberate self-harm (DSH) is one of the common psychiatric emergencies in medical practice. Very few studies have discussed this maladaptive behavior in Egypt. We conducted this study to evaluate possible motives, modes, and psychiatric comorbidities in patients of DSH. Methods: This institution based cross - sectional study, included 100 cases of deliberate self-harm referred for liaison consultation in the institute of psychiatry , Ain Shams university after attending to the university general hospital emergency room. Patients were assessed by Structured Clinical Interview for DSM-IV Axis I Disorders (SCID-I), SCID-II for Axis II Personality Disorders, Columbia-Suicide Severity Rating Scale (C-SSRS), and Self- Punishment Questionnaire. Relevant sociodemographic data were collected. Data analyses were done using suitable tests. Results: The mean age of participants was 22.21±2.02 (years). The most common self-injurious behavior was Cutting (63%) followed by shooting (15%), Hitting (11%), Hanging & Burning (9%), respectively. The most commonly used tool was the sharp objects (64%) followed by gun (15%), wood, stone & others (11%), rope, fire & electricity (10%). The most common injured body sites were extremities (79%) followed by head and neck (14%), abdomen & trunk (7%). 36% of the case group had psychiatric disorders; Adjustment disorder (13%), Mixed anxiety-depressive (17%), Schizophrenia (paranoid)(6%).Nearly 100 % of the sample had personality problems ; borderline personality disorder (59%), Mixed personality traits (avoidant, dependent, passive aggressive, schizotypal, paranoid, borderline) (41%).Correlation studies were significant for the study different variables with (P value < 0.01) . Conclusions: Deliberate self-harm is strongly linked to many psychiatric disorders and personality problems. Suicidal thoughts and behavior, all with self-punishment, were strongly correlated to this behavior. Consequently, there is a need for a more comprehensive psychiatric evaluation for all self- harm cases.

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