Hospital care and repetition following self-harm: multicentre comparison of self-poisoning and self-injury
Rachael Lilley,David Owens,Judith Horrocks,Allan House,Rachael Noble,Helen A. Bergen,Keith Hawton,Deborah Casey,Sue Simkin,Elizabeth Murphy,Jayne Cooper,Navneet Kapur +11 more
TLDR
Hospital services offer less to people who have cut themselves, although they are far more likely to repeat, than to those who have self-poisoned, and attendance at hospital should result in psychosocial assessment of needs regardless of method of self-harm.Abstract:
Background
Quantitative research about self-harm largely deals with self-poisoning, despite the high incidence of self-injury.
Aims
We compared patterns of hospital care and repetition associated with self-poisoning and self-injury.
Method
Demographic and clinical data were collected in a multicentre, prospective cohort study, involving 10 498 consecutive episodes of self-harm at six English teaching hospitals.
Results
Compared with those who self-poisoned, people who cut themselves were more likely to have self-harmed previously and to have received support from mental health services, but they were far less likely to be admitted to the general hospital or receive a psychosocial assessment. Although only 17% of people repeated self-harm during the 18 months of study, survival analysis that takes account of all episodes revealed a repetition rate of 33% in the year following an episode: 47% after episodes of self-cutting and 31% after self-poisoning ( P <0.001). Of those who repeated, a third switched method of self-harm.
Conclusions
Hospital services offer less to people who have cut themselves, although they are far more likely to repeat, than to those who have self-poisoned. Attendance at hospital should result in psychosocial assessment of needs regardless of method of self-harm.read more
Citations
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Journal ArticleDOI
Non-suicidal self-injury v. attempted suicide: new diagnosis or false dichotomy?
TL;DR: What self-harm research can tell us about the concept of NSSI is considered and the potential pitfalls of introducing N SSI into clinical practice are examined.
Journal ArticleDOI
Psychosocial interventions for self‐harm in adults
Keith Hawton,Katrina Witt,Tatiana Taylor Salisbury,Ella Arensman,David Gunnell,Philip Hazell,Ellen Townsend,Kees van Heeringen +7 more
TL;DR: There was a significant treatment effect for CBT-based psychotherapy compared to TAU at final follow-up in terms of fewer participants repeating SH, but for interventions typically delivered to individuals with a history of multiple episodes of SH/probable personality disorder, group-based emotion-regulation psychotherapy and mentalisation were associated with significantly reduced repetition.
Journal ArticleDOI
Interventions for self‐harm in children and adolescents
Keith Hawton,Katrina Witt,Tatiana Taylor Salisbury,Ella Arensman,David Gunnell,Ellen Townsend,Kees van Heeringen,Philip Hazell +7 more
TL;DR: This is an update of a broader Cochrane review on psychosocial and pharmacological treatments for deliberate SH and finds that mentalisation therapy was associated with fewer adolescents scoring above the cut-off for repetition of SH based on the Risk-Taking and Self-Harm Inventory 12 months post-intervention.
Journal ArticleDOI
Epidemiology and trends in non-fatal self-harm in three centres in England, 2000–2012: findings from the Multicentre Study of Self-harm in England
Galit Geulayov,Navneet Kapur,Pauline Turnbull,Caroline Clements,Keith Waters,Jennifer Ness,Ellen Townsend,Keith Hawton +7 more
TL;DR: A substantial increase in self-injury occurred in the latter part of the study period, especially marked for self-cutting/stabbing and hanging/asphyxiation.
Journal ArticleDOI
Risk factors for fatal and nonfatal repetition of suicide attempts: a literature review.
TL;DR: It is difficult to find predictors for repetition of nonfatal suicide attempts, and even more difficult to identify predictors of completed suicide.
References
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TL;DR: Estimated rates of intentional self- Harm from two ongoing surveys and data from the Toxic Exposure Surveillance System suggest that, for every 2002-2003 suicide, there were 12 (NEISSAIP) or 15 (NHAMCS) self-harm-related emergency department visits, and for every intentionalSelf-poisoning death there were 33 intentional overdoses reported to poison control centers.
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