Failed suicide and deliberate self-harm: A need for specific nomenclature

BACKGROUND: Out of those who attempted self-harm and survived, many actually wanted to die and many did not. Presently, no distinctive nomenclature exists for these two groups, which causes difficulty in understanding as well as in management and research. AIM: To study whether there exist two such groups which are distinct and can be differentiated clinically. METHODS: Seventy-eight persons who attempted self-harm were evaluated in detail by a psychiatrist. The data were recorded in an especially designed proforma which documented sociodemographic variables, psychiatric and physical illnesses, psychosocial stress factors, substance abuse, past and family history and details of suicide attempt. RESULTS: Two groups emerged with distinct characteristics. The two groups were different in factors such as age, diagnosis, intentionality, lethality, mode, motive to kill oneself, past/family history, relation to stress, personality traits and precaution to prevent detection before and/or after the act. The group which had persons who really wanted to die but survived is suggested to be named as the ‘failed suicide’ group and the other group which had persons who did not actually want to die is suggested to be named as the ‘deliberate self-harm’ group. CONCLUSION: Those who cause harm to themselves but survive can be distinctly put into two groups: (i) the ‘failed suicide’ group constituting those who actually wanted to kill themselves and (ii) the ‘deliberate self-harm’ group constituting those who did not actually want to die. The criteria for distinctions are suggested.