Biological disturbances and deliberate self-harm in children and adolescents with psychiatric disorders: do we need to keep a watch in the night?

BACKGROUND: The Biological disturbances (BD) in sleep, appetite, bowel movements, and changes in sexual interests have been associated with psychiatric disorders in children and adolescents. This has not been studies well in the Indian context. AIM: This prospective cross-sectional study aims to document relationship between the BD and Deliberate self-harm (DSH) among children and adolescents with psychiatric disorders. METHOD: The institutional review board permission was obtained, data was collected using specially designed proforma by trainee psychiatrist after obtaining written consent from parent and child. The analysis was done using univariate and multivariate logistic regression. The statistical significance was set at P=0.05 and all tests were two tailed. SPSS (version 16) was used. RESULTS: Eighty parents and children participated in the study and mean standard deviation of age was 13.99 (2.52) years and there were 55% girls and 45 % boys. Participants had ICD 10 diagnosis of mood disorders (F32.0-8), anxiety disorders (F40.0-9, F41.0-9, F42.0-9, F43.2-8), eating disorder (F 50.0-2), dissociative disorder (F 44.4,5), somatoform disorders (F45.1,4,9) and behavioral problems nos. (F 98.9). In univariate logistic analysis, a significant relationship between DSH and BD [ β (SE)=1.48(0.81), p=0.06; OR=4.39] was found. In multiple logistic regression when confounders of the diagnosis, scholastic difficulty, peer relationship, socio economic status, age were controlled, relationship between the BD and DSH became more significant [ β (SE)=2.06(1.00), p=0.04; OR=7.85]. CONCLUSION: DSH is about 8 times more among children and adolescents with BD in their psychiatric disorder and hence immediate treatment in this population is necessary.