Background Deliberate self-harm (DSH) represents intentional self-inflicted physical injury encompassing both non-suicidal self-injurious acts and suicide attempts, constituting a significant psychiatric emergency with profound morbidity implications. Individuals with personality disorders demonstrate substantially elevated suicide attempt rates compared to those without personality pathology. Comprehensive psychosocial assessment remains fundamental for evaluating DSH presentations. While research has investigated socioeconomic determinants and personality disorders among adolescent populations, investigations examining general adult populations remain limited. This study determined personality profiles among DSH patients and investigated relationships between sociodemographic factors and DSH behaviors. Methodology This analytical cross-sectional investigation enrolled 193 adults presenting with DSH to the RL Jalappa Hospital Psychiatry Department, Sri Devaraj Urs Medical College, Kolar, Karnataka, India, between September 2022 and December 2023. Comprehensive histories were obtained through patient interviews and reliable informant collateral and discussed with departmental psychiatrists. Personality diagnoses were established according to the International Classification of Diseases, 10th Revision (ICD-10) and the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) criteria using the International Personality Disorder Examination screening questionnaire, with responses documented and scored. Results Among 193 participants, the mean age was 31 years (31.46±9.75), with 99 females (51.3%) and 94 males (48.7%). Lower socioeconomic status characterized 70% (n=136), while 132 were unmarried (68.4%). Ninety-three participants were unemployed (48.2%), with 164 from rural areas (84.9%). One hundred eleven participants (57.5%) attempted DSH without psychiatric illness, whereas 82 (42.5%) had psychiatric comorbidity: adjustment disorders, 33 cases (17.1%), depression, 22 cases (11.4%). One hundred and three participants (53.4%) reported previous suicide attempts. Family conflicts precipitated stress (n=60, 60.6%) and financial difficulties (n=22, 22.2%). Methods included liquid poison in 127 cases (65.8%), multiple tablets in 28 (14.5%), hanging in 24 (12.4%), and self-cutting in 15 (7.8%). Substance abuse affected 97 participants (50.25%). Borderline personality predominated in 48 cases (24.9%), dependent in 42 (21.8%), and impulsive in 27 (14%). Cluster B constituted 98 cases (50.8%), Cluster C 66 (34.2%), and Cluster A 29 (15%). Significant Cluster B associations included younger age, female gender, lower education, lower socioeconomic status, unmarried status, unemployment, recurrent attempts, stressors, substance abuse, and the liquid poison method (p<0.05). Conclusion Psychiatric disorders constitute established self-harm risk factors, with findings demonstrating literature consistency. Cluster B personality disorders, particularly borderline traits, predominate among DSH presentations. Multiple sociodemographic vulnerabilities, including younger age, female gender, socioeconomic disadvantage, unemployment, and substance abuse, are significantly associated with personality clustering. Larger investigations warrant a comprehensive personality profile evaluation among suicide attempters.
Mashru et al. (Thu,) studied this question.