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Clinical Research Case Report

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Dr. Saurabh Kumar

MBBS, M.D. (Psychiatry) 15 years experience overall Psychiatrist , Neuropsychiatrist , Sexologist

Self-harm attempts with corrosive 'acid' among patients referred to psychiatric emergency services: Observations and implications

Published In: The National Medical Journal of India

About The National Medical Journal of India: The National Medical Journal of India is a highly respected, peer-reviewed publication that covers a wide range of medical topics, focusing on the unique healthcare challenges in India. It serves as a crucial platform for both clinical research and public health discussions, contributing to the advancement of medical knowledge and practices in the Indian context.


Abstract

Key Findings of the Research:

  1. Prevalence of Acid Ingestion for Self-Harm: The study analyzed a year’s worth of data from the psychiatric emergency services at the All India Institute of Medical Sciences, New Delhi, focusing on patients who presented with deliberate self-harm. Of the total psychiatric emergencies, 9.6% were self-harm attempts, and within this group, 15% had ingested corrosive acid. This finding underscores the prevalence of acid ingestion as a relatively common means of self-harm in India.
  2. Demographic Profile: The mean age of patients who attempted self-harm through acid ingestion was 25.3 years, with women comprising 70% of the cases. The majority of these incidents were impulsive, unplanned actions often triggered by interpersonal conflicts, such as family disputes or relationship failures.
  3. Psychological Background of Patients: While some patients had a history of major psychiatric disorders like depression or psychosis, most had no prior psychiatric diagnosis, indicating that acid ingestion is often a result of acute emotional distress rather than long-standing mental illness. Many initially reported the ingestion as accidental, highlighting the stigma and legal concerns associated with documented suicide attempts.
  4. Public Health and Regulatory Implications: The study critiques the lack of effective enforcement of regulations governing the sale of corrosive substances, despite the introduction of legal measures to control acid sales in India. The unrestricted availability of concentrated acids at a low cost makes them a common choice for both household use and impulsive self-harm. The authors call for stricter regulations and public education on the safe storage and handling of such substances.
  5. Recommendations for Prevention: The authors stress the need for increased awareness about the risks of acid ingestion and suggest that cost-effective alternatives to corrosive acid cleaners be promoted to reduce their availability in homes. They also recommend that psychiatric assessments in emergency settings include inquiries into potential triggers for impulsive self-harm attempts, allowing for more effective interventions.

Applicability to the General Population:

This study holds significant public health implications for India and other regions where corrosive substances are readily available. The findings suggest that self-harm by acid ingestion is a largely preventable issue, contingent on better regulation and public awareness. The study also highlights the importance of understanding the emotional triggers behind impulsive self-harm and calls for more comprehensive mental health interventions in emergency services.

For the general population, the research underscores the need for vigilance in the storage and use of household acids, as well as the importance of recognizing early signs of emotional distress in loved ones. By fostering better awareness and promoting safer alternatives to corrosive cleaners, society can take meaningful steps to reduce the incidence of self-harm.

In conclusion, "Self-harm Attempts with Corrosive Acid among Patients Referred to Psychiatric Emergency Services" offers critical insights into an underreported public health issue. Dr. Saurabh Kumar and his colleagues highlight the role that both regulatory enforcement and public education must play in preventing self-harm attempts involving corrosive substances, ultimately contributing to a more effective approach to mental health care and crisis prevention.
Author Information: Pattanayak, Raman Deep, Saurabh Kumar, and S. K. Khandelwal. "Self-harm attempts with corrosive'acid'among patients referred to psychiatric emergency services: Observations and implications." The National Medical Journal of India 29, no. 3 (2016): 182.

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