Epidemiological profile of hospitalized self-harm in Chile differs from suicide profile. 2008-2017

Abstract

Abstract Background Suicide is a public health problem. The highest rates occur in men of 45-60 years old, and the most common methods are hanging, ingestion of pesticides, and firearms. Self-harm with or without suicide intention is the most critical factor identified for prevention, and it requires health care services. In Chile, the central-south regions are the most vulnerable areas. We described the epidemiological profile and trends of hospitalized self-harm in Chile between the years 2008 and 2017 and identified susceptible geographical regions and subpopulations. Methods We analyzed the codes X60-X84 (ICD-10) for self-harm, from the hospital discharge records of the Department of Health Statistics of Chile. Chilean population data (National Statistics Institute) and standard world population information were used to adjust self-injury rates by age. Administrative shapefiles containing boundaries of standard geographic locations were obtained from the Chilean National Congress website. We analyzed data by sex, groups of age, and by administrative Region. Self-injury mechanisms were grouped into six categories. Results For the period 2008-2017, 31,363 cases of self-harm were hospitalized. The global self-harm rate for the period was 20.9 per 100.000 inhabitants, 29.5 for women, and 12.0 for men. For age groups 10-19, 20-64, and 65 or more, these rates were 40.4, 15.1, and 7.9, respectively. The highest self-harm rates were observed in the north and central regions (Arica:43.5, O'higgins:37.9, Valparaiso:35.4). The most common methods of self-harm were drugs/substance use (89%), sharp and blunt objects use (4.4%), and hanging/drowning (3.1%). In men, the letality rate of self-harm was 2.5% and 0.6% in women. Conclusions In Chile, hospitalized self-harm rates are high in women and adolescents, mainly in the north and central regions of the country. Key messages Prevention of suicide should be targeted in different populations than the already known epidemiological profile of suicide. Self-harm should be a public health concern, for prevention and surveillance, especially in adolescents and women.