Comparative study of self harm behavior among adults with alcohol dependence syndrome and depressive disorder

Abstract

Self-harm is a salient component for upcoming risk behaviors in an individual that constitute to considerable jeopardy of the rest of their social and emotional well-being. As per estimate of WHO, globally, life time prevalence of substance use disorder and mood disorder are 10.7% and 9.6% respectively. These are two major psychiatric conditions that are commonly seen in India. Knowledge about vulnerable population for self-harm in these conditions can help us to address their needs and thereby reduce the risk of further self-harm. The objective of this study is to assess the prevalence, socio-demographic details and clinical factors associated with self-harm behavior in patients with alcohol dependence syndrome and those with depression. This was a cross sectional study of 312 patients, 156 of them with Alcohol dependence syndrome and 156 of them with depression diagnosed according to ICD 10 criteria. Study population included patients whose age was above 18 years, without any other co-morbid psychiatric or organic mental disorder. Descriptive analysis was carried out by mean and standard deviation for quantitative variables, frequency and proportion for categorical variables. The association between socio-demographic and clinical parameters and self-harm behavior was assessed by cross tabulation and comparison of percentages. Odds ratio along with 95% CI is presented. Chi square test was used to test statistical significance. Self-harm is directly correlated with the severity of the illness and inversely correlated with age of onset of illness. Early age of onset and severe illness are associated with self-harm behavior. In ADS individuals, marriage can be a risk factor for Self-harm, where as in depression, it is considered to be protective. The study has highlighted the prevalence of self-harm in specific psychiatric conditions, which are most often neglected or under reported. It can thus be concluded that prevalence of selfharm behaviors in both the conditions is equal. There are risk factors specific to the illness , which make an individual vulnerable to self-harm attempts and these population should be monitored vigorously.