Impact of COVID-19 lockdown on self-harm and violence among patients presenting to the emergency department - 09/12/21

Doi : 10.1016/j.ajem.2021.11.008

Suhrith Bhattaram ^a, Varsha S. Shinde ^a , Ishan Lamba ^a,^{^⁎} , Rebecca S. Gladwin ^a, Kadainti Venkata Subbaraya Sharma ^b
^a Department of Emergency Medicine, Dr DY Patil Medical College, Pimpri, Pune, Maharashtra 411018, India
^b Sivadurga Residency, HIG 216&217, Kukatapally, Hyderabad 500072, India

^⁎Corresponding author.

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Abstract

Importance

Considering the resurgence of COVID19 and the rapid spread of new and deadlier strains across the globe understanding the incidence and pattern of violence and self harm tendencies during this period might help in formulating better contingency plans for future lockdowns. A deeper look at the available data shows that there is a significant dearth of research into self-harm & violence during the COVID-19 pandemic.

Objective

To identify the incidence and sociodemographic characteristics of self-harm and violence during the COVID19 lockdown and compare with a control group from the previous year.

Design

A cross-sectional retrospective observational study.

Setting

Tertiary care teaching hospital.

Participants

All patients presenting to the emergency department (ED) with self harm and violence during the COVID-19 lockdown period between March 24–June 30, 2020 and March 24–June 30, 2019.

Exposure

The COVID-19 lockdown period.

Main outcome (s) and measure (s)

The hypothesis being tested was formulated before the study. The null hypothesis tested was a decline in number of self-harm and violence cases during the lockdown.

Results

A total of 828 patients were analysed over both the time periods, out of which 30% (248) were females while 70% (580) were males. Increases in self-harm and violence were 12.71% and 95.32% respectively per 1000 ED admissions.

A significant correlation was found between the COVID-19 lockdown and the increased incidence (X2 (1, N = 828) = 9.2, p < .05). An increase of violence by known individuals and between partners was seen. Intimate partner violence also increased to 7%. X2 (3, N = 662) = 21.03, p < .05. In the self harm dataset an increase in mortality, ICU admissions and decision to leave against medical advice was noted (X2 (4, N = 166) = 24.49, p < .05). Increase in the use of alcohol prior to acts of self harm and violence was noted.

Conclusions

Increase in the incidence of cases of self-harm and violence reported to the ED was noted during the lockdown period. Upgradation of health-care and law enforcement infrastructure maybe needed to deal with similar circumstances in a more efficient manner.

Trial registration: N/A.

Il testo completo di questo articolo è disponibile in PDF.

Highlights

•	Increased incidence of self-harm and violence during the COVID-19 lockdown period.
•	Violence was the predominant mode of injury with increased intimate partner violence.
•	Increased ICU admissions and increased mortality was seen in cases of self-harm.
•	Use of alcohol prior to acts of violence and self-harm increased significantly during the lockdown.

Il testo completo di questo articolo è disponibile in PDF.

Keywords : Self harm, Violence, COVID-19 in India, COVID-19, COVID-19 lockdown self harm in India