Changing Dynamics of Self-harm by Attempted Suicidal Hanging During the COVID-19 Pandemic

To, The Editor, Medical Journal of Dr. D. Y. Patil Vidyapeeth Sub: Comments on an article published in the recent issue of your esteemed journal. Dear Sir/Madam, We read with interest the article “Changing dynamics of self-harm by attempted suicidal hanging during the COVID-19 pandemic” by Nair et al. that was published in the Dr. D. Y. Patil Vidyapeeth Medical Journal. We congratulate the authors for a well-designed study. However, we have some comments: Firstly, the study’s conclusions cannot be generalized to other institutions because it only used data from one. The authors combined historical data with data from a local intensive care unit (ICU). While historical data offer a useful overview, it might not fully represent broader patterns in self-harm in India or other LMICs. Second, based on a small sample size (25 cases after the epidemic), the authors report a threefold increase in self-harm by hanging during the pandemic. Concerns regarding statistical power and the reliability of the results are raised by the small number of cases. Small sample sizes may cause trends to be overestimated or underestimated and may fail to take other confounding factors influencing the rates of self-harm into account.[1] It is challenging for the study to compare clinical outcomes and demographic traits between the pre- and post-pandemic periods. For example, the mean age of patients increased from 29.8 to 33.3 years, but this shift was not found to be statistically significant. However, this analysis might have missed other important characteristics that could have contributed to this change, such as socioeconomic status or mental health disorders. The lack of a thorough investigation of these variables undermines the study’s conclusions regarding the pandemic’s effects on various demographic groups.[2] The study also emphasizes that family conflicts are a major reason why people self-harm after a pandemic. Although this result is intriguing, it is important to keep in mind that there were notable shifts in pandemic limitations and economic conditions during the data gathering period, which ran from July 2021 to January 2022. To understand how different levels of lockdown severity and economic stress caused the reported increase in family disagreements, a more detailed analysis of this environment is necessary.[3] Finally, while the study’s conclusion on the need for creative suicide prevention strategies for young adults is correct, it is not very precise. The foundation of recommendations ought to be a thorough examination of social support networks, mental health resources, and focused treatments made to address the particular requirements the study found.[4] Data availability statement Please contact corresponding author for any data required. Author contribution All authors contributed equally to reviewing the literature, analysis, interpretation of data and drafting the article. Financial support and sponsorship Nil. Conflicts of interest There are no conflicts of interest.