Increasing incidence of admissions to a general hospital for deliberate self-harm in Trinidad.
BACKGROUND
Deliberate self-harm and suicidal behaviour have become an increasingly common form of morbidity in the developing world Suicidal behaviour is a major public health problem in Trinidad as the country has the second highest completed suicide rate in the English-speaking Caribbean. The objectives of this study were to determine the epidemiology of attempted suicide and self-harm at a specified site (the Port-of-Spain General Hospital) and compare it to previous studies done at the same site.


METHODS
This was investigated through a review of one years' admissions to the Port-of-Spain General Hospital for suicidal behaviour. Incidence was compared with a previous study completed at this site and reported in 1974. Comparison of the demographic characteristics of the sample with that of the previous study was also undertaken using chi-square analysis and significance testing through the use of t tests.


RESULTS
A total of 368 referrals were made for attempted suicide or deliberate self-harm over the period indicating a fourfold increase in the incidence of this behaviour with a greater increase among males where the female to male ratio has declined from 4 to 1 to 2 to 1, p < 0.001; the mean age of males was 34 years compared to females 22 (p < 0.0001). The males were more likely to use violent means compared to females who were more likely to ingest tablets or bleach. Relationship difficulties were most commonly cited by both males and females as the reason for their attempt. There was a trend to greater propensity for this behaviour among Indo-Trinidadians as compared to Afro-Trinidadians in both females and males.


CONCLUSIONS
Increasing numbers of men are engaging in self-harm behaviour and are using more violent and physically harmful methods suggesting a greater degree of suicidal risk while women mainly engage in acts of ingestion with a much lower risk of death. The older mean age of these men suggests that their problems are presenting in middle adulthood while women are engaging in this behaviour in young adulthood. Suicidal behaviour or deliberate self-harm is a major public health problem in Trinidad.
Hutchinson
G
G
Psychiatry Unit, Faculty of Medical Sciences, The University of the West Indies, Mount Hope, Champs Fleurs, Trinidad, West Indies. gahrad@gmail.com
Bruce
C
C
Simmons
V
V
D000328:Adult; D000367:Age Factors; D005260:Female; D006769:Hospitals, General / Q000706:statistics & numerical data*; D006801:Humans; D015994:Incidence; D008297:Male; D012189:Retrospective Studies; D012307:Risk Factors; D016728:Self-Injurious Behavior / Q000453:epidemiology*; D012737:Sex Factors; D013405:Suicide / Q000706:statistics & numerical data; D014300:Trinidad and Tobago / Q000453:epidemiology