Self-harm and interpersonal violence in the Middle East and North Africa: a three-decade epidemiological analysis

Despite being a major public health concern, self-harm and interpersonal violence (SH/IPV) have not been comprehensively evaluated in the Middle East and North Africa (MENA). Therefore, by using the Global Burden of Disease (GBD) study data on SH/IPV in this region for the first time in the study period from 1990 to 2021, we investigated (1) trends in the age-standardised incidence rate (ASIR), age-standardised mortality rate (ASMR) and age-standardised disability-adjusted life-years (DALY) rate (ASDR) attributable to SH/IPV across the region over three decades and (2) the association between the sociodemographic index and ASDR.

We assessed trends in ASIR, ASMR and ASDR from 1990 to 2021 using GBD data, applying locally estimated scatterplot smoothing regression to evaluate the association between sociodemographic index values and ASDR across the region.

During the study period, ASIR, ASMR and ASDR attributable to SH/IPV increased in the MENA region by 78%, 34% and 34%, respectively. Afghanistan had the highest ASDR at 9392 (95% uncertainty interval: 8281-11,065), while Yemen showed the largest increase (614%). In 2021, conflict and terrorism had the highest ASDR at 770 (95% uncertainty interval: 687-875). An inverse correlation between sociodemographic index and ASDR suggested that higher sociodemographic status was associated with lower ASDR attributable to SH/IPV.

The rising burden of SH/IPV in the MENA region is concerning, with sociopolitical and economic factors playing key roles.

Public health strategies should target SH/IPV in MENA to mitigate the observed trends.