Pattern of emergency department presentations for deliberate self-harm at a tertiary care hospital in Pakistan: A cross-sectional study

Abstract

Objective

Deliberate self-harm (DSH) is a complex event with multitude of contributing factors. The emergency department has an essential role as first point of contact with patients who present with DSH. We aimed to determine the pattern of DSH presenting in emergency department of a tertiary care hospital in Pakistan.

Method

Following ethical approval, data including demographics, methods, reasons, and intent were collected for 6 months (January–June 2022) and analyzed using SPSS-26.

Results

485 cases (53.2% males) with mean age of 29 years (SD ± 13.16), were included. More than half (55.4%) were married with urban predominance (81.9%). One-fourth of patients were housewives. The most frequent DSH method was ingestion of a poisonous substance (95.1%), followed by firearms (1.2%). Among ingested substances, intake of wheat pills (23.1%), corrosives/acid (11.5%), and bleach (10.3%) was frequent. Immediate triggers for DSH included family conflicts (16.3%), intent to put pressure on family (17.7%), financial reasons (11.3%), and to get out of a situation (7.2%). Twenty-two percent (106) people had an intent to die. There were almost three presentations of DSH per day.

Conclusion

Ingestion of poisonous substances, due to easy availability, highlights ongoing gaps that the policymakers can address to reduce the burden of DSH in Pakistan.