Self-Immolation in the Arab World: A Systematic Review

INTRODUCTION: Self-immolation is the centuries-old act of setting fire to oneself. Recent spikes in self-immolation events have been noticed in the Arab world, specifically in the aftermath of the Arab Spring in 2011. OBJECTIVES: To examine the literature assessing the characteristics and patterns of suicide by self-immolation in the Arab world. METHODS: We registered our systematic review in Prospero [CRD42020207164]. We searched PubMed, Medline, PsycInfo, Embase, and Scopus databases from inception until 6 September 2021. We collected relevant articles via title and abstract screening followed by full-text screening. We then conducted a narrative synthesis of the results. RESULTS: We found 31 out of 314 articles that fit our inclusion criteria: 4 qualitative and 27 quantitative cross-sectional studies. The quantitative studies had a sample size ranging from 22 to 600 self-inflicted burn victims. The studies emanated from Iraq (n=16), Tunisia (n=6), Saudi Arabia (n=2), Libya (n=2), Jordan (n=2), and Egypt, Palestine and Bahrain collectively (n=3). Studies showed that self-immolators are commonly married females, age ranging between 13 and 66 years old, having no education or solely primary education, and of low socioeconomic status. Self-immolation was more likely to happen at home, usually following marital conflicts, with the primary motive being suicide. Studies highlighted an increase of self-immolation as a form of protest. Kerosene was the most commonly used accelerant. Depression was the most comorbid mental health diagnosis. CONCLUSIONS: Self-immolation is not uncommon in the Arab world. Specific interventions directed at the population at risk are warranted. DISCLOSURE: No significant relationships.