Epidemiology and socio-demographic risk factors of self-immolation: A systematic review and meta-analysis

Self-immolation or self-inflicted burn is the most tragic and violent method of suicide. The higher prevalence of this dramatic phenomenon in Iran is a serious social and health problem. In this study, we conducted a meta-analysis to combine the results from available studies to examine the epidemiology and socio-demographic characteristics of individuals who attempted self-immolation in Iran.

Pertinent studies were identified by searching the electronic bibliographic databases including PubMed, Scopus, Science Direct, Iran Medex, Magiran, Medlib and Scientific Information Database (SID) (2000-October 2016). Meta-analysis was used to summarize the research results on socio-demographic risk factors of self-immolation in Iran. The STROBE checklist was used to assess quality of the study. The random effect model was employed in the meta-analysis to account for the observed heterogeneity among the selected studies.

Twenty-nine studies (sample size=5717) were included in the meta-analysis. The estimated average age of individuals who attempted self-immolation was 27.31 (95% confidence interval [CI]: 25.81-28.81) years. Women account for 70% (95% CI: 64-77) of all self-immolation attempts in Iran. Thirty-nine (95% CI: 34-43) per cent of all self-immolation were among singles. Nineteen (95% CI: 16-22) per cent of self-immolators had mental disorder. Meta-regression model showed that the average age of individuals who attempted self-immolation increased significantly over the period between 2000 to 2016 (P-value=0.006).

Our study indicated that individuals who attempted self-immolation in Iran were mainly women, married and young adults.