Epidemiological study of committed self-inflicted burns admitted to the Hospitals of Kermanshah, University of Medical Sciences, Iran (2004-2005)

Suicide by burning is a rare condition in the developed countries (0.06% -1% of all suicides), but is more frequent in the developing countries (up to 40.3% of all suicides). In different parts of Iran, between 1.39- 9.50% of patients that attempted suicide and 25.0-40.3% of patients who committed suicide have been reported through deliberate self-burning. Self-burning (immolation) comprises between 0.37% and 40% of total burn center admissions around the world and in Iran, it is comprises between 4.1% and 36.6% of admissions in Iranian burn centers. Approximately, 80% of hospitalized self-immolation patients die. The goal of this study was to identify the epidemiologic features, causes and potential protective factors of suicide by burning in Kermanshah province in the west of Iran, and to develop the effective intervention programs based on the Public Health Approach to Prevention.
Methods and Materials: Over the course of a year, from 21 March 2004 up to 20 March 2005 (Based on Iranian Calendar), the authors examined all the suicidal patients who were admitted to the emergency department of hospitals in Kermanshah University of Medical Science. Examination included a retrospective cross-section observational study, via demographic questionnaires and suicidal checklists.
Results: Over the period of study, 1820 patients who attempted suicide and 90 patients who successfully committed suicide were admitted. 41% (37 cases) of patients who committed suicide were via self-immolation. 81% of self-immolation patients were female (p<0.0005), and the female: male ratio was 4.3. 86.6 and a half percent of the patients were in the 11- 30 years of age group. The mean age was 24.9 years (range: 14 - 50 years). Forty-nine percent of cases were single, 84% were illiterate or in low level of education. 78.5% were housewives, and 14% were unemployed. Also, most of the patients (53%) were living in rural area, ninety-seven percent did not have a previous history of suicide attempt, and 67.5% regretted their self-immolation act. The majority of the self-immolation (64.8%) occurred during daylight hours, and the most common self-immolation motivation factor was marital conflict (32.5%).
Conclusion: Overall, this study demonstrates that self-immolation should be considered as a mental health problem in our society. It is necessary to implement programs and strategies to prevent this problem. The public health approach provides a framework for a National Prevention Strategy to address this serious national problem. Local data on victims and victim stories from self-immolation provided the stimulus for community action