Abstract
Objective
To study the nature of deliberate self-harm (DSH) in children and to identify the associated factors.
Setting
Child Guidance Clinic attached to the Department of Pediatrics of a teaching hospital in South India.
Subjects
Children with history of deliberate self harm who were referred to the CGC for psychological evaluation during a 10 year period.
Methods
Children and parents were interviewed together and separately and details regarding age, sex, family and school environment, stresses and nature of self harm were documented. Psychiatric diagnosis was made based on DSM IV diagnostic criteria.
Results
Among the 30 children included in the study, 21 were boys and 9 were girls. Majority of children were between the ages of 11 and 13 years, the youngest being 6 years old. 76% of children had history of acute stressful life events and 62% of them had chronic ongoing stress. 62 % of children had stress in the family and 41% had stress at school. Stress in the family included death of a parent, conflicts with parents or siblings, mental illness in the family, parental alcoholism and parental disharmony. Stress at school included conflicts with classmates, punishment or negative comments by teachers and learning problems. Psychiatric disorders were present in 52% of children, the commonest being depressive disorder. The commonest mode of DSH was self poisoning, and rat poison (zinc phosphide) was the commonest substance used.
Conclusions
Deliberate self harm occurs in young children and the risk factors are comparable to those in adolescents.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Hawton K, Rodham K, Evans E, Weatherall R. Deliberate self harm in adolescents: self report survey in schools in England. BMJ. 2002;325:1207–1211.
Resch F, Parzer P, Brunner R; BELLA study group. Self-mutilation and suicidal behaviour in children and adolescents: prevalence and psychosocial correlates: results of the BELLA study. Eur Child Adolesc Psychiatry. 2008;17:92–98.
Hawton K, Harriss L. Deliberate self-harm by under-15-year-olds: characteristics, trends and outcome. J Child Psychol Psychiatry. 2008;49:441–448.
Sourander A, Aromaa M, Pihlakoski L, Haavisto A, Rautava P, Helenius H, et al. Early predictors of deliberate self-harm among adolescents. A prospective follow-up study from age 3 to age 15. J Affect Disord. 2006;93:87–96.
Brunner R, Parzer P, Haffner J, Steen R, Roos J, Klett M, et al. Prevalence and psychological correlates of occasional and repetitive deliberate self-harm in adolescents. Arch Pediatr Adolesc Med. 2007;161:641–649.
Hawton K, Zahl D. Suicide following deliberate self-harm: long-term follow-up of patients who presented to a general hospital. Br J Psychiatry. 2003;182:537–542.
Portzky G, van Heeringen K. Deliberate self-harm in adolescents. Curr Opin Psychiatry. 2007;20:337–342.
Krishnakumar P, Geeta MG, Gopalan AV. Deliberate selfpoisoning in children. Indian Pediatr. 2005;42:582–586.
American Psychiatric Association: Diagnostic and Statistical Manual of Mental Disorders, 4th edn (DSM-IV) Washington, DC, American Psychiatric Association, 1994.
Adams DM, Overholser JC, Spirito A. Stressful life events associated with adolescent suicide attempts. Can J Psychiatry. 1994;39:43–47.
National Institute of Mental Health, 1992. Diagnostic Interview Schedule for Children. (DISC-C) Version 2.3.
Resnik H, Hathorne B. Suicide Prevention in the 70’s. Washington, DC: US Government Printing Office; 1973.
Sidhartha T, Jena S. Suicidal behaviors in adolescents. Indian J Pediatr. 2006;73:783–788.
Dutta AK, Seth A, Goyal PK, Aggarwal V, Mittal SK, Sharma R, et al. Poisoning in children: Indian scenario. Indian J Pediatr. 1998;65:365–370.
Singh S, Singhi S, Sood NK, Kumar L, Walia BNS. Changing pattern of childhood poisoning (1970–1989): Experience of a large Indian hospital. Indian Pediatr. 1995; 32:332–336.
Madge N, Hewitt A, Hawton K, de Wilde EJ, Corcoran P, Fekete S, et al. Deliberate self-harm within an international community sample of young people: comparative findings from the Child and Adolescent Self-harm in Europe (CASE) Study. J Child Psychol Psychiatry. 2008;49:667–677.
Kumar CTS, Chandrasekaran R. A study of psychosocial and clinical factors associated with adolescent suicide attempts. Indian J Psychiatry. 2000;42:237–242.
Arun P, Chavan BS. Stress and suicidal ideas in adolescent students in Chandigarh. Indian J Med Sci. 2009;63:281–287.
Mahadevan S, Hawton K, Casey D. Deliberate self-harm in Oxford University students, 1993–2005: a descriptive and case-control study. Soc Psychiatr Epidemiol. 2009 Apr 25. [E pub ahead of print].
Sharma R, Grover VL, Chaturvedi S. Suicidal behavior amongst adolescent students in south Delhi. Indian J Psychiatry. 2008;50:30–33.
Chitsabesan P, Harrington R, Harrington V, Tomenson B. Predicting repeat self-harm in children—how accurate can we expect to be? Eur Child Adolesc Psychiatry. 2003;12: 23–29.
Richardson AS, Bergen HA, Martin G, Roeger L, Allison S. Perceived academic performance as an indicator of risk of attempted suicide in young adolescents. Arch Suicide Res. 2005;9:163–166.
McClure GMG. Suicide in children and adolescents in England and Wales 1970–1998. Br J Psychiatry.2001;178: 469–464.
Jacobson CM, Muehlenkamp JJ, Miller AL, Turner JB. Psychiatric impairment among adolescents engaging in different types of deliberate self-harm. J Clin Child Adolesc Psychol. 2008;37:363–365.
Lalwani S, Sharma GA, Kabra SK, Girdhar S, Dogra TD. Suicide among children and adolescents in South Delhi (1991–2000). Indian J Pediatr. 2004;71:701–703.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Krishnakumar, P., Geeta, M.G. & Riyaz, A. Deliberate self harm in children. Indian Pediatr 48, 367–371 (2011). https://doi.org/10.1007/s13312-011-0084-z
Received:
Revised:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s13312-011-0084-z