Psychiatric Morbidity and Self-Harm in South Asia: A Systematic Review

BACKGROUND: Self-harm is a multifaceted public health issue attributed to psychiatric and non-psychiatric factors that prevail all over the world. However, the rate of psychiatric disorders in self-harm in South Asia has yet to be assessed. OBJECTIVE: We aimed to assess the prevalence of psychiatric morbidity in individuals with self-harm in South Asia. METHODS: Following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, we conducted a systematic search across three databases: Medline, PsycINFO, and Embase for peer-reviewed studies published from 1990 to 2024. Articles with estimates of psychiatric disorders in individuals with self-harm within South Asia were included. RESULTS: Fifty three studies with 8,254 persons with self-harm met the criteria and were included in this systematic review. The studies were hospital-based, mostly cross-sectional, where participants were female and married individuals aged 15-34 years. The prevalence of psychiatric disorders was 61.3%. Depression and adjustment disorders were the most frequent diagnoses among persons with self-harm. Interpersonal conflicts and financial difficulties were noted as non-psychiatric factors. CONCLUSION: The revealed prevalence of psychiatric disorders among persons with self-harm in South Asia underscores the need for targeted mental health interventions to prevent self-harm and suicidal behavior in the region.