Self-immolation a common suicidal behaviour in eastern Sri Lanka.
A high number of self-burning injuries are noted in Batticaloa. The epidemiology, outcome and psychosocial aspects of 87 patients admitted with such burns over a 2-year-period was studied. The patients were compared with accidental burns and patients using other methods of suicide. Seventy nine percent of the victims were females and 72% were in the 15-34 years age-group. Most had marital problems. The majority were Tamils, but Muslims were fairly well represented. The median extent of burn was 48% of total body surface area (TBSA), with the top of the body mainly affected. The use of fire proved to have a high mortality in a group of patients who did not really want to die; 61 (70%) died. Mortality was higher than for accidental burns after matching for age and burn extent. The survivors had long hospital stays and suffered severe disfigurement. The cases where the patient denied self-harm, but in which the injuries were suggestive of this motive, were strikingly similar in age, sex and burn extent to the suicide group. In contrast, poison suicide records showed a male predominance and a gross under-representation of Muslims. Fire is a very significant method of suicide in our area. Social make-up and poor problem-solving ability may be contributing factors.