RESUMO
OBJECTIVE: Deliberate self-harm (DHS) is a deviant behavior that has been not completely emphasized in health-related studies in Iran. The current study was conducted to explore the prevalence and reasons associated with the incidence of DSH in patients referring to the emergency room of Baradaran-e Rezaee Hospital in Damghan, Iran. METHODS: Fifty-four clients with the mean age of 29.4 (±10.3) years participated in this cross-sectional study in 2010. Firstly, demographics and details of substance use were collected based on items elicited from the Addiction Severity Index (ASI) and a researcher-made questionnaire. Then details of comorbidity and factors associated with the current DHS were collected by a semi-structured interview. Data were analyzed by performing descriptive methods of statistics. RESULTS: Deliberate self-poisoning with using toxic substances such as lead, and poison (44.8%) followed by drug intoxication such as opiate and methamphetamine (35.2%) and body and vessel cutting (20%) were the most prevalent types of DSH. Furthermore, results revealed that comorbidities such as physical illness (38.9%) and psychiatric disorders including depression (31.5%), psychotic symptoms (15%), bipolar disorder (5.6%), stress (5.6%), and anxiety (1.9%) were commonly prevalent. The most frequently reported factors associated with DSH were desires for self-punishing (42%), self-medication for emotional sufferings (33%), experiencing euphoric feelings (24%), and stress (20%), respectively. CONCLUSION: DSH is one of the critical health and treatment priorities, which are prevalent in emergency rooms of hospitals in Iran. Clients with comorbid diagnosis of DSH, especially drug use warrant specific attention in emergency rooms.
RESUMO
OBJECTIVE: High purity heroin use is a new epidemic health concern among Iranian drug-using women in recent years. However, the nature and initial factors associated with this serious health problem have not been studied yet. METHODS: To understand this issue, a cross-sectional study was conducted and sixty treatment and non-treatment seekers who met the Diagnostic and Statistical Manual of Mental Disorders, 4(th) ed., Text Revision (DSM.IV-TR) criteria for drug dependence with mean age of 28.7 (± 8.3) years were recruited from 16 addiction clinics and drop-in centers (DICs) in Karaj, Iran. First, demographics, and details of drug use and risky behaviors were collected based on items elicited from Addiction Severity Index (ASI). Then, initial factors associated with high purity heroin use were collected by interviewing and applying a researcher-made questionnaire. Data was statistically analyzed by descriptive methods of statistics, chi-square, and Student's independent t-test in SPSS software. RESULTS: Initiation of high purity heroin use was facilitated by family/relatives factor (66.7%), curiosity (60.1%), peers (54%), desire to experience rapid physical effects of high purity heroin compared with other opioids (50.1%), and treatment of general medical problems such as colic pain (33%). Chi-square test showed that non-treatment seekers were younger (less than 35 years) (66.6% vs. 56%, p ≤ 0.001) and mostly living with drug-dependent friends (26% vs. 3.3%, p ≤ 0.001) compared with treatment seekers. No relation was found among other factors. CONCLUSIONS: Factors facilitating the initiation of high purity heroin use revealed in this study have not been fully addressed by current drug treatment services in Iran. To design comprehensive treatment programs, further studies on larger samples with more women are necessary. DECLARATION OF INTEREST: None.