This study provides a comprehensive analysis of the epidemiological features, methods, and outcomes of self-harm and suicide attempts in Kurdistan, highlighting the critical areas for intervention. These results were combined with regional and worldwide statistics in the discussion, with a focus on the consequences for clinical practice and public health. Key findings highlighted important areas for intervention: 83.6% of patients were discharged following treatment, 16.4% died, and 71% of cases included drug overdoses.
Young adults, especially those between the ages of 17–40, were the most susceptible. This age range reflects a time in life when there are many psychological and social demands such as marital problems, job uncertainty, and academic difficulties. Owing to the employment of more deadly techniques and delays in seeking medical attention, older persons may have greater death rates. The increased fatality rates among guys may be a result of their preference for more brutal techniques, such as hanging [17, 18]. These findings emphasize the significance of implementing gender- and age-sensitive interventions such as crisis counseling services and mental health education initiatives.
Our results are in line with research from other low- and middle-income nations that likewise emphasizes the higher lethality of male-performed methods and the prevalence of self-harm among young people. Similar trends have been seen in the method selection by gender, with women typically depending on drug overdose and men more likely to employ violent methods like hanging [19, 20]. The study’s seasonal tendencies, which include spring and summer peaks, are consistent with earlier findings that indicate a higher prevalence of self-harm during warmer months. Contrary to our findings, several studies carried out in more urbanized settings suggest lower recovery rates among women. This could be due to variations in family support or access to emergency treatment [21]. Furthermore, although there has been a general correlation between chronic illnesses and an increased risk of suicide, our results show a particularly strong correlation with cardiac disorders, which calls for more research [22].
Kurdistan has a slightly higher death rate and a higher prevalence of violent methods like hanging than other Iranian regions like Tehran and Ilam [23]. These discrepancies could be explained by regional variances in healthcare access, socioeconomic difficulty, and financial resources. For example, research from Tehran has shown a decrease in mortality and an increase in drug overdoses, which may be the result of improved emergency response facilities [24, 25]. On the other hand, Kurdistan’s cultural and economic pressures, such as the shame associated with mental health and the dearth of available support resources, can lead to worse consequences.
Drug overdose is the most common technique, comparable that to in low- and middle-income countries. This trend emphasizes the need to restrict access to OTC medicine and raise awareness of its misuse. However, hanging and poisoning, which have greater fatality rates, require community education on spotting suicide tendencies and early intervention. Gender disparities in technique selection emphasize the necessity for gender-specific support groups and safe medicine disposal measures to address men and women’s hazards [19, 26]. Given the identification of the spring and summer peaks, environmental and cultural factors may influence self-harm [20, 27]. Social and familial stress may be associated with increased psychological distress, especially in vulnerable people. The lower incidence and higher recovery rates in winter may be due to fewer social activities and increased family support. Seasonal mental health programs during high-risk periods may help to mitigate these patterns [21].
Mental health conditions, substance abuse, and chronic illnesses were significantly linked to self-harm and suicide attempts. The fact that anxiety and depression were present in almost half of the cases emphasizes the urgent need for mental health services to be incorporated into primary care settings. Routinely evaluating at-risk individuals for psychological distress, particularly those with chronic conditions, can significantly reduce the burden of self-harm [28]. Since substance use has been found to be a significant cause of death, specific interventions, such as addiction counseling and recovery programs, are required. Promoting an open and supportive culture requires addressing the stigma associated with substance abuse and mental health issues through public-awareness initiatives [29].
Results were substantially correlated with marital status; those who were single had a somewhat higher recovery rate than those who were married. This could be a result of varying degrees of peer pressure or help-seeking behavior, especially in traditional cultural contexts where marriage can bring on new difficulties [30]. Furthermore, a history of previous suicide attempts was found in 20% of individuals and was likewise substantially associated with the results. This highlights how suicidal conduct is chronic and repeated and that people who have attempted suicide in the past require long-term monitoring and mental health treatment.
This study highlights several areas for improvement in clinical practice and policies. Qualified professionals must work in emergency rooms to properly diagnose and manage suicide risks. It is important to establish standardized procedures for handling cases of self-harm, which should include psychological evaluation and follow-up care [31]. Policymakers, particularly in underprivileged areas such as Kurdistan, must prioritize funding for the development of mental health infrastructure. Furthermore, community-based programs that involve non-governmental groups and local leaders might improve the acceptance and accessibility of mental healthcare. Understanding the socioeconomic factors that contribute to suicide and assessing the efficacy of current therapies should be the focus of future research.
This study had several limitations that should be acknowledged. First, as a cross-sectional study, it captures data at a single point in time, limiting its ability to infer causality. Second, the study’s reliance on hospital records could potentially introduce reporting bias, as it excluded cases that did not present to emergency departments. Due to insufficient medical records, the retrospective design of this study may have resulted in underreporting or missing data. Furthermore, cases that did not show up at emergency rooms were not recorded. Notwithstanding these drawbacks, the credibility of our results is supported by standardized data collection and a sizable sample drawn from several hospitals.
There is a possibility of misclassification due to reliance on clinical judgment to determine intent, and not all cases received a formal psychiatric evaluation, which may affect data accuracy. We recognize the conceptual and clinical distinctions between self-harm and suicide attempts, despite the fact that they are frequently examined combined for epidemiological purposes. While suicide attempts frequently indicate a desire to die, self-harm without suicidal intent may result from emotional regulation requirements. To improve clinical specificity, future research should take into account analyzing these subgroups independently. Also, the conceptual and clinical distinctions between self-harm and suicide attempts, despite the fact that they are frequently examined combined for epidemiological purposes was found. While suicide attempts frequently indicate a desire to die, self-harm without suicidal intent may result from emotional regulation requirements. To improve clinical specificity, future research should take into account analyzing these subgroups independently.
Despite these limitations, this study had several strengths. It provides a large sample size from multiple hospitals, thus enhancing the generalizability of the results within the Kurdistan region. The use of standardized data collection methods and robust statistical analyses ensured reliability and validity. This study also fills an important research gap by focusing on the societal, cultural, and demographic factors that affect self-harm. This study provides useful information for designing public health interventions that work in similar situations. Future research should focus on long-term evaluations of prevention strategies and explore innovative, culturally sensitive solutions to address this persistent public health challenge.