Faculty of Medicine, University of Belgrade, Belgrade, Serbia.
Clinic for Burns, Plastic and Reconstructive Surgery, University Clinical Center of Serbia, Belgrade, Serbia.
Front Public Health. 2024 Feb 21;12:1234584. doi: 10.3389/fpubh.2024.1234584. eCollection 2024.
Self-immolation is an uncommon way of attempting and committing a suicide, with a fatality rate of 80%. The risk factors in self-immolation victims vary depending on demographic characteristics, socio-economic and cultural factors as well as religious beliefs. Whether the COVID-19 pandemic was a potentially important stressor for self-immolation is still unknown, with insufficient studies examining this issue. Therefore, in this study, we aimed to examine the trend of self-immolation in a 13-year timeline, and the potential association of COVID-19 pandemic with the increase in the incidence and severity of self-immolation injuries in Serbia in 2021.
The study included hospitalized patients due to intentional burns caused by self-immolation in the period from January 1, 2008 to December 31, 2021. Joinpoint regression analysis was used for the analysis of continuous linear trends of self-immolation cases with change points.
While a rising trend was observed in the 2008-2013 time segment, followed by a decline in the upcoming 2013-2016 time segment, a significant increase reached its maximum during COVID-19 pandemic (2021), with annual percent change of 37.1% ( = 0.001). A significant increase in the median number of cases per year was observed during 2021 compared to the previous periods (7.5 vs. 2). Frequency of patients with a psychiatric diagnosis vs. those without a psychiatric diagnosis was significantly higher during than before the COVID-19 period (66.7 vs. 36.1%, = 0.046).
In our study, a significant increase in the frequency of suicide attempts by self-immolation during COVID-19 pandemic was noticed. There was also an increased frequency of pre-existing psychiatric illness among patients during the pandemic period. With limited high-quality data available, the study adds to a rising body of evidence for assessment of outcomes of the pandemic on mental health and recognition of stressors for self-immolation.
自焚是一种较为少见的自杀方式，致死率为 80%。自焚者的风险因素因人口统计学特征、社会经济和文化因素以及宗教信仰而异。 新冠疫情是否是自焚的一个潜在重要压力源尚不清楚，目前还没有足够的研究来探讨这个问题。因此，在这项研究中，我们旨在检查塞尔维亚自焚在 13 年时间内的趋势，并研究新冠疫情与 2021 年自焚伤害发生率和严重程度增加之间的潜在关联。
本研究纳入了 2008 年 1 月 1 日至 2021 年 12 月 31 日期间因自焚导致的故意烧伤住院患者。使用 Joinpoint 回归分析对自焚病例的连续线性趋势进行分析，并确定变化点。
虽然在 2008-2013 时间段观察到上升趋势，随后在 2013-2016 时间段下降，但在新冠疫情期间（2021 年）达到了显著增加，年变化百分比为 37.1%（ = 0.001）。与前几个时期相比，2021 年每年的病例中位数显著增加（7.5 对 2）。在新冠疫情期间，有精神科诊断的患者比例明显高于疫情前（66.7%对 36.1%， = 0.046）。
在我们的研究中，注意到新冠疫情期间自焚自杀的频率显著增加。在疫情期间，患者中先前存在的精神疾病的频率也有所增加。由于可用的高质量数据有限，该研究增加了越来越多的证据，以评估疫情对心理健康的影响，并认识到自焚的压力源。
