Sociodemographic Development and Influencing Factors of the Global Burden of Self-Harm, 1990-2021: Findings from the Global Burden of Disease Study 2021

Abstract

BACKGROUND: Self-harm is a significant global public health challenge with substantial psychological and economic impacts. This study analyzes trends in self-harm, focusing on the effects of the COVID-19 pandemic and sociodemographic index (SDI) on self-harm outcomes. We aim to explore the association between temporal trends, SDI, and the global burden of self-harm. METHODS: Data from the Global Burden of Disease Study 2021 were used to evaluate age-standardized prevalence (ASPR), incidence (ASIR), mortality (ASMR), and disability-adjusted life years (DALYs) rates across 204 countries. Percentage changes from 2019 to 2021 and estimated annual percentage change (EAPC) from 1990-2021 were calculated, and Spearman's correlation was used to analyze relationships between EAPC and SDI. Risk factors for self-harm mortality were also assessed. RESULTS: In 2021, 746,379 global deaths from self-harm were reported (ASMR = 8.99 per 100,000). Both ASPR and ASIR increased during the COVID-19 pandemic. Greenland had the highest burden, while South Asia showed significant sex differences, particularly higher prevalence and incidence among females. The burden of self-harm was elevated among individuals aged 70 and above. A positive correlation was found between ASMR and EAPC, and a negative one with SDI. High alcohol use accounted for 9.3% of self-harm deaths. CONCLUSIONS: The study highlights the need for targeted mental health interventions, particularly in regions like Greenland, South Asia, and among older adults. The pandemic's impact on self-harm rates underscores the urgency of mental health support, especially in lower SDI regions, to mitigate risk factors such as high alcohol use.