An observational study on deliberate self-harm in individuals with alcohol dependence syndrome.

Context: Comorbidities in alcohol dependence syndrome (ADS) are often associated with poor treatment outcomes and high service utilization. Deliberate self-harm (DSH) in India is a silent epidemic. There is a shortage of research on individuals with ADS, psychiatric comorbidities, and DSH.

Aim: To study DSH and psychiatric comorbidity in persons with ADS.

Settings And Design: A cross-sectional study of 1-year duration is conducted in out patient department/indoor patient department of a tertiary care hospital.

Methods And Material: Eighty-one individuals with ADS were selected purposefully. A semi-structured pro forma, the severity of alcohol dependence questionnaire, Mini-International Neuropsychiatric Interview (MINI), and Deliberate Self-Harm Inventory were administered for assessment. The statistical analysis used is as follows: correlation statistics and logistic regression.

Results: Most subjects were married, belonged to upper-middle socioeconomic status, had at least secondary education, and had moderate alcohol dependence severity. Almost 3/4 of the subjects had at least one lifetime psychiatric disorder. A past episode of major depressive disorder was found in 47%. Nearly 20% of study subjects had a history of DSH, which was significantly associated with unmarried status, and earlier age of alcohol dependence. Marital status, educational level, and age of onset of alcohol dependence explain 64.3% of the variance in DSH attempts. Suicidality was significantly related to the presence of DSH.

Conclusions: The study found a high prevalence of psychiatric disorders and a history of DSH in individuals with ADS. The study confirmed the association between DSH and suicidality and indicated a specific subpopulation of ADS who need thorough clinical assessments to recognize these psychiatric comorbidities and DSH.