A Comparison of Characteristics of Patients Hospitalized for Self-Harm Before and During the COVID-19 Pandemic: A Retrospective Study

Abstract

Background: The COVID-19 pandemic has had widespread impacts on mental health and social contexts, which may be associated with changes in factors related to self-harm. However, in-depth data at the hospital level remains limited.

Objective: To compare demographic characteristics, health-related factors, methods of self-harm, and precipitating factors among patients admitted for self-harm before and during the COVID-19 pandemic.

Methods: This retrospective study included 191 inpatients admitted for self-harm at Pathum Thani Hospital between 2019 and 2020, categorized into pre-COVID-19 and during-COVID-19 periods. Data were obtained from electronic medical records. Variables of interest included demographic characteristics, precipitating factors, methods of self-harm, and predisposing risk factors. Descriptive statistics were used to summarize the data, and differences between groups were analyzed using the Chi-square test or Fisher’s Exact Test. Statistical significance was set at p<0.05.

Results: The mean age of participants was 34.89±14.31 years, and the majority were female (61.8%). No significant differences were observed between the two periods in demographic characteristics, psychiatric diagnoses, or methods of self-harm. However, alcohol use significantly decreased during the pandemic period (p=0.024), while relationship-related precipitating factors significantly increased (p=0.030). During the COVID-19 pandemic, interpersonal and family-related factors appeared to play a more prominent role in triggering self-harm, despite no significant changes in baseline patient characteristics.

Conclusion: The findings of this study indicate that interpersonal relationship problems are an important factor associated with self-harm behavior during the COVID-19 pandemic period. Therefore, healthcare services and mental health agencies should integrate the assessment of relationship problems involving family members, spouses, and significant others into routine screening procedures for self-harm and suicide risk. In addition, surveillance systems and mental health counseling services should be strengthened to address interpersonal and family conflicts alongside psychiatric treatment. Such measures may help reduce the risk of repeated self-harm among vulnerable populations during the pandemic.