Document Type : Original Article
Authors
- Beryl Ini Prasantha 1
- Renju Mathew Alex 1
- Jangala Sai Supriya 1
- Thomas Vinod Thomas 2
- Kakileti Mercy Theophila 1
- Priyanjali venkata Chode 1
- Reginald George Alex 3
1 Junior Resident, Department of Medicine chittoor campus, Christian Medical College Vellore, India
2 Department of Medicine, Christian Medical College and Hospital, Vellore, Chittoor campus
3 Professor and head of chittoor medicine department, Department of Medicine chittoor campus , Christian Medical College Vellore, India
Abstract
Background: Deliberate self-harm (DSH) represents a largely under-recognized public health crisis in low- and middle-income countries, particularly affecting young adults. Despite its significant contribution to morbidity, mortality, and long-term psychological and socioeconomic consequences, it continues to receive insufficient attention in public health agendas. We aim to describe the socio-demographic and clinical characteristics of patients who presented with DSH to a secondary care hospital in South India.
Methods: This retrospective study was conducted using electronic medical records of patients presenting with DSH to the Emergency Department of a secondary care hospital in South India between 2019 and 2024. Data on sociodemographic characteristics, methods of self-harm, clinical features, and referral outcomes were extracted and analyzed. Descriptive statistics were used to summarize the findings.
Results: Of 61,797 Emergency Department visits over five years, 179 (0.29%) were due to DSH. The mean (SD) age was 31.8 (14.1) years, with a slight female predominance (50.8%); most patients were aged 15–30 years (58.7%). Toxic ingestion was the predominant method, with agrochemicals forming the largest group (31.8%), followed by medication overdose (15.1%) and corrosive ingestion (11.2%); hanging accounted for 17.9% of cases. Most patients were referred to tertiary centres (64.8%), while 22.3% were admitted locally. Emergency department mortality was 1.7%.
Conclusion: DSH remains a substantial public health burden in India, especially among young adults. The high proportion of impulsive, high-lethality attempts highlights the urgent need to strengthen emergency mental health services, pesticide regulation, and preventive strategies at the secondary care level.
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- Greydanus DE, Shek D. Deliberate Self-harm and Suicide in Adolescents. The Keio Journal of Medicine. 2009;58(3):144–51. DOI: 10.2302/kjm.58.144
- Toxicoepidemiology of Acute Poisoning: A Classic Tale of Two Indias. Indian Journal of Critical Care Medicine. 2024 Mar 30;28(4):315–6. DOI: 10.5005/jp-journals-10071-24692
- Hawton K, Saunders KE, O’Connor RC. Self-harm and suicide in adolescents. The Lancet. 2012 June 23;379(9834):2373–82. DOI: 10.1016/S0140-6736(12)60322-5
- Sharma V, Marshall D, Fortune S, Prescott AE, Boggiss A, Macleod E, et al. Prevention of self‐harm and suicide in young people up to the age of 25 in education settings - Sharma, V - 2024 | Cochrane Library. [cited 2026 Jan 11]; Available from: https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD013844.pub2/full
- Abhilash KPP, Murugan S, Rabbi NAS, Pradeeptha S, Kumar S, Selvaraj B, et al. Deliberate self-poisoning and harm: A meticulous quest of methods in vogue. Journal of Family Medicine and Primary Care. 2022 Jan;11(1):233. DOI: 10.4103/jfmpc.jfmpc_1184_21
- Jegaraj MKA, Mitra S, Kumar S, Selva B, Pushparaj M, Yadav B, et al. Profile of deliberate self-harm patients presenting to Emergency Department: A retrospective study. Journal of Family Medicine and Primary Care. 2016 Mar;5(1):73. DOI: 10.4103/2249-4863.184627
- Bonvoisin T, Utyasheva L, Knipe D, Gunnell D, Eddleston M. Suicide by pesticide poisoning in India: a review of pesticide regulations and their impact on suicide trends. BMC Public Health. 2020 Feb 19;20(1):251. DOI: 10.1186/s12889-020-8339-z
- Dhooria S, Agarwal R. Amitraz, an underrecognized poison: A systematic review. Indian J Med Res. 2016 Sept;144(3):348–58. DOI: 10.4103/0971-5916.198723
- Somani A. Suicide among Adolescents and Young Adults in India: A Huge Concern and a Little Respite at Hand. Indian Journal of Social Psychiatry. 2025 Mar;41(1):1. DOI: 10.4103/ijsp.ijsp_6_25
- Biological Factors Underpinning Suicidal Behaviour: An Update [Internet]. [cited 2026 Jan 11]. Available from: https://www.mdpi.com/2076-3425/13/3/505
- Student Suicide in India: An Analysis of Newspaper Articles (2019–2023) - Maji - 2025 - Early Intervention in Psychiatry - Wiley Online Library [Internet]. [cited 2026 Jan 11]. Available from: https://onlinelibrary.wiley.com/doi/10.1111/eip.13616
- Mental Health, Suicidality, Health, and Social Indicators Among College Students Across Nine States in India - Anish V. Cherian, Gregory Armstrong, H. Sobhana, Tilahun Haregu, Sonia P. Deuri, Shrinivasa U. Bhat, Agnieta Aiman, Vikas Menon, Anil V. Cherian, Yamini Kannappan, Tinu Thamby, Soyuz John, V. A. Pavithra, Sonali S. Tesia, Sujit Gosh, Shukhdeba S. Hanjabam, John Gaingamlung Gangmei, Manisha Kiran, Veronica Nriame, R. M. Ravindra, 2025 [Internet]. [cited 2026 Jan 11]. Available from: https://journals.sagepub.com/doi/10.1177/02537176241244775?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub%20%200pubmed
- The national suicide prevention strategy in India: context and considerations for urgent action - The Lancet Psychiatry [Internet]. [cited 2026 Jan 11]. Available from: https://www.thelancet.com/journals/lanpsy/article/PIIS2215-0366(21)00152-8/abstract
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