Self-immolation in Iran.

Deliberate self-inflicted burn is rare in high-income countries, but is reported more frequently in low- and middle-income countries, especially in Asia and Africa. Rates in Iran are among the highest in the world, with up to 71% of committed suicides conducted via self-immolation in some regions. The objective of this study was to identify the epidemiologic features and factors of self-immolation in Iran to aid in development of effective intervention programs. In a review study, two national databases were analyzed to identify demographic, geographic, cultural, economic, and health-related aspects of self-immolation that may vary across regions of Iran. Demographic information revealed that 27% of suicide cases in Iran were via self-immolation. Of those, 71% were female. The mean age was 29 years. Geographical features of self-immolation indicated that the self-immolation rate was higher in rural areas and in provinces that border the country. Provinces that were involved more intensively in postwar problems feature higher rates of self-immolation. People of Kurdish ethnicity were more likely to engage in self-immolation. Unemployment was a risk factor for self-immolation, while mental disorders and lack of access to health and treatment facilities did not play an important role for increasing the rate of self-immolation. Overall, this study demonstrates that self-immolation is a significant public health problem in some parts of Iran. This study clearly and consistently shows that self-immolation is a complex phenomenon with multiple causes. Various intervention options are discussed to increase coping skills on the individual and community levels. During the long-term, programs and strategies should focus on "macrosocial-based" interventions.