Deliberate Self Harm in Children.

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.