Exploration of the association between contact history, socio-cultural factors and acute deliberate self-poisoning in North Central province of Sri Lanka: a case-control study

Abstract

Background Knowledge of someone else's suicidal behaviour significantly increased the risk of similar acts. Though Sri Lanka has implemented a national policy and an action plan to prevent suicides and attempted suicides, in 1997, the number of deliberate self-harm (DSH) incidents is increasing. We conducted a case-control study to identify the precipitants and to assess the possible impact of a contact history for acute deliberate self-poisoning (DSP) in view of identifying possible interventions. Materials and Methods We interviewed two hundred DSP patients, admitted to the medical wards of Teaching Hospital Anuradhapura (THA), during June - August 2004. Patients were randomly selected from a block of two consecutively admitted consenting DSP patients and an interviewer-administered questionnaire was completed. Age and sex-matched patients, who had no history of attempted suicide, admitted to medical wards of THA were interviewed as controls. Results Majority of DSP occurred among adolescents and young adults. Conflicts within the family and simple conflicts with someone else were the triggers for the majority (n=123, 61.5%, 95% CI 58.1-64.9%) of DSP. Our study showed that DSP was common among people who had not completed primary education (OR 4.5, 95% CI 2.5-7.9, p Conclusions DSP behaviour in rural Sri Lanka seems to be a learned response of vulnerable adolescents and young adults to deal with stressful situations. An in-depth exploration of this finding is needed in order to use it as a key factor in the identification of risk groups for DSP prevention.