Exploration of Associations Between Deliberate Self-Poisoning and Psychiatric Disorders in Rural Sri Lanka: A Case Control Study

Abstract

Background Psychiatric disorders are important predictors of self-harm behaviour. The present study was carried out to determine associations between DSM-IV TR Axis-I & II disorders and deliberate self poisoning (DSP) in a Sri Lankan rural agricultural district. Methods Patients who had attempted DSP, who resided within the district were selected randomly for the study. Both the cases and age, sex and residential area matched controls were assessed for DSM-IV TR Axis-I & II disorders based on the Structured Clinical Interview for DSM-IV-TR Axis I and II Disorders (SCID I & II) conducted by a specialist psychiatrist. Results Cases consisted of 207 (47.3%) males and 231 (52.7%) females. TR axis-I and/or TR axis-II psychiatric diagnoses was found in 89 (25.6%) of cases and 14 (3.2%) controls. Cases with a TR axis-I diagnosis were older (32 and 19 years), p < 0.0001. Having a depressive episode was associated with a 13 time higher risk for DSP. Being a male aged > = 30 years and having an alcohol use disorder carried a 21 time excess risk for DSP. A vefold excess risk for DSP was found among 10-19 years old females with borderline personality traits. Conclusions Depressive disorder and alcohol related disorders were signi cantly associated with older participants who had attempted DSP. The prevalence of psychiatric disorders among DSP in rural Sri Lanka is signi cantly lower than reported rates in western countries. Health and research priorities to reduce self-harm in Sri Lanka will also need to address non-psychiatric issues