Domestic violence, mental health, and repeat self-harm in Sri Lanka

Background Evidence on the risk factors for repeat self-harm from low- and middle-income countries is scarce and requires urgent attention. Aims We sought to examine psychosocial correlates of repeat self-harm in Kandy, Sri Lanka. Methods Logistic regression models (adjusting for age and sex) were used to examine associations between study factors and repeat self-harm among adult patients (N=292) admitted for self-poisoning. Results Depression (OR 2.8 95% CI 1.7-4.7), prior psychiatric diagnosis (OR 4.8 95% CI 2.2-10.2), past-year exposure to suicidal behaviour (OR 1.9 95% 1.1-3.3), physical/sexual abuse (OR 3.0 95% CI 1.3-6.9), and psychological abuse (OR 2.3 95% CI 1.3-4.2) were strongly associated with repeat self-harm. Conclusions Identification and management of domestic violence and psychiatric morbidity should be part of routine clinical assessments of patients presenting with self-harm.