Citation

Jeremic JV, Mihaljevic JM, Radosavljevic ILJ, Jurisic MM, Suđecki BJ, Stojicic MT, Jovanović MD, Pavlović Z, Radenovic KG, Milic NV, Pavlovic V, Milic NM, Jovic MS. Front. Public Health 2024; 12: e1234584.

Copyright

(Copyright © 2024, Frontiers Editorial Office)

DOI

10.3389/fpubh.2024.1234584

PMID

38450141

PMCID

PMC10914977

Abstract

INTRODUCTION: 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.

MATERIALS AND METHODS: 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.

RESULTS: 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% (p = 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%, p = 0.046).

CONCLUSION: 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.

Language: en

Keywords

*COVID-19/epidemiology; *Mental Disorders; burns; COVID-19; Data Accuracy; Humans; joinpoint regression; mental health; Mental Health; Pandemics; self-immolation; suicide