Pattern of Deliberate Self Harm in Children

Abstract

Background: Deliberate self-harm refers to an intentional self inflicted injury with or without the desire to die. It includes cutting, scratching, hitting oneself, intentional drug overdose, food restriction, and other risk-taking behaviors like speeding or unsafe sexual activity. Risk factors include psychopathology, family conflict, unstable caregiving, and maltreatment. Children who self-harm often have psychiatric illnesses such as depression, mood or anxiety disorders, conduct problems, and an increased risk of suicide.

The present study aimed to analyze the pattern of deliberate self-harm in children below 15 years of age and identify associated factors.

Methods: This retrospective cross-sectional study was conducted at Nepalgunj Medical College, Kohalpur, from November 2022 to October 2024. Data were collected from the medical records of children admitted to the Pediatric Intensive Care Unit for deliberate self-harm. After stabilization, all children underwent psychiatric evaluation.

Results: Among 42 children, the male-to-female ratio was 1:2. The youngest child was 8 years old, and most (57.1%) were 14 years old. Self-poisoning, mainly by organophosphorus compounds and rat poison (zinc phosphide), was the most common method (78.6%), followed by hanging (9.5%). Major triggers included family-related stress (68.4%) followed by school stress (44.7%).Depression was present in 38.09% of the children, and 26.19% had definite suicidal intent. Depression was significantly associated with suicidal intent (p < 0.01).

Conclusion: Deliberate self-harm is common in children. Self poisoning was the most common method. The attempts were both impulsive and associated with suicidal intent. Depression and acute psychosocial stressors were major triggers, highlighting the urgent need for targeted prevention strategies.