Increased self-immolation frequency and severity during the COVID-19 pandemic

OBJECTIVE: To determine whether the increased restrictions, isolation and stressors associated with COVID-19 led to an increase in rates or severity of self-immolation burn injuries. DESIGN: Retrospective review of a prospectively-collected database of New South Wales burn patients, comparing 2020 data with the preceding 5 years. SETTING: Both adult units in the New South Wales Statewide Burn Injury Service (Concord Repatriation General Hospital and Royal North Shore Hospital). PARTICIPANTS: All adult patients in New South Wales with self-inflicted burn injuries between 1st January 2015 and 31st December 2020. OUTCOME MEASURES: Demographic information, precipitating factors, burn severity, morbidity and mortality outcomes. RESULTS: We found18 episodes of self-immolation in 2020, compared to an average of 10 per year previously. Burn size significantly increased (43% total body surface area vs 28%) as did revised Baux score (92 vs 77). Most patients had a pre-existing psychiatric illness. Family conflict and acute psychiatric illness were the most common precipitating factors. CONCLUSION: 2020 saw an increase in both the frequency and severity of self-inflicted burn injuries in New South Wales, with psychiatric illness a major factor.