title: A case-control study of psychosocial risk and protective factors of self-immolation in Iran.
abstract: Self-immolation is the third leading cause of years of life lost (YLL) among women in Iran. The aim of this study is to investigate self-immolation-related risk and protective factors in the western region of Iran, a province with the highest prevalent of self-immolation in the country. Using a case-control design, we compared 151 cases of self-immolation attempters who were admitted to a burn center in Kermanshah with 302-matched control group from the same community/locality between March 21st, 2009, and March 20th, 2012. We conducted descriptive, bivariate, and multivariate analysis to examine the associations of self-immolation with demographic and familial risk factors, adverse life events, mental disorders, as well as potential protective factors. According to our findings, the highest percentage of self-immolation was in the 16-25 year-old age group (60%) and in females (76%). Of the potential risk factors in the study, major depression, adjustment disorders, individual history of suicide attempts and opium dependence, were statistically significant predictors of self-immolation. Suggestions for translating the local picture of self-immolation portrayed by our findings, into meaningful prevention strategies that have a good fit with the social and interpersonal context within which self-immolation takes place are discussed.
authors.affiliation: Department of Anesthesiology, Critical Care and Pain Management, Imam Reza Hospital, Kermanshah University of Medical Sciences, Kermanshah, Iran; Department of Public Health Sciences, Division of Social Medicine, Karolinska Institutet, Stockholm, Sweden. Electronic address: ahmadiar1012@yhaoo.com.
authors.forename: Alireza
authors.initials: A
authors.lastname: Ahmadi
authors.affiliation: Department of Public Health Sciences, Division of Social Medicine, Karolinska Institutet, Stockholm, Sweden.
authors.forename: Reza
authors.initials: R
authors.lastname: Mohammadi
authors.affiliation: Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran.
authors.forename: Afshin
authors.initials: A
authors.lastname: Almasi
authors.affiliation: Department of Anesthesiology, Critical Care and Pain Management, Imam Reza Hospital, Kermanshah University of Medical Sciences, Kermanshah, Iran.
authors.forename: Javad
authors.initials: J
authors.lastname: Amini-Saman
authors.affiliation: Injury Epidemiology & Prevention Research Center, Statistics and Epidemiology Department, School of Health & Nutrition, Tabriz University of Medical Sciences, Tabriz, Iran.
authors.forename: Homayoun
authors.initials: H
authors.lastname: Sadeghi-Bazargani
authors.affiliation: Department of Psychiatry, Charles R. Drew University of Medicine and Science and David Geffen School of Medicine at University of California, Los Angeles, CA, USA. Electronic address: shahrzadbazargan@cdrewu.edu.
authors.forename: Shahrzad
authors.initials: S
authors.lastname: Bazargan-Hejazi
authors.affiliation: Department of Public Health Sciences, Division of Social Medicine, Karolinska Institutet, Stockholm, Sweden.
authors.forename: Leif
authors.initials: L
authors.lastname: Svanström
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D002053:Burn Units / Q000706:statistics & numerical data; D002056:Burns / Q000453:epidemiology / Q000209:etiology*; D016022:Case-Control Studies; D005195:Family Relations; D005260:Female; D006801:Humans; D007492:Iran / Q000453:epidemiology; D008016:Life Change Events; D016015:Logistic Models; D001523:Mental Disorders / Q000150:complications; D008875:Middle Aged; D015999:Multivariate Analysis; D065840:Protective Factors; D012307:Risk Factors; D016728:Self-Injurious Behavior / Q000453:epidemiology / Q000523:psychology*; D012737:Sex Factors; D019966:Substance-Related Disorders / Q000150:complications; D013406:Suicide, Attempted / Q000523:psychology* / Q000706:statistics & numerical data; D055815:Young Adult
keywords: Adjustment disorders; Adverse life events; Familial risk factors; Major depression; Self-immolation; Suicide