Citation

Kapur N, Johnston A, Cooper J, Webb R. Psychiatr. Danub. 2006; 18(Suppl 1): 65.

Affiliation

Centre for Suicide Prevention, University of Manchester, Williamson Building, Oxford Road, M13 9PL Manchester, UK. (nav.kapur@manchester.ac.uk)

Copyright

(Copyright © 2006, Facultas Universitatis Studiorum Zagrabiensis - Danube Symposion of Psychiatry)

DOI

unavailable

PMID

16963961

Abstract

Background: Few individual-level interventions have been shown to reduce repetition rates of self-harm. Area-level interventions may be an alternative but no ecological studies have examined the relationship between area characteristics and self-harm repetition. Aims: To investigate the association between individual and area-level factors and the repetition of self-harm. Method: Prospective cohort study using the Manchester Self-Harm database. Adults who were resident in Manchester, UK and presented to an Emergency Department following self-harm between 1997-2002 were included (N=4743). The main outcome measure was repeat self-harm within six months. Results: Area-based factors (e.g. deprivation, low income, and employment status) were strongly related to self-harm incidence rates but not to rates of repetition. A multivariate analysis identified four individual factors (previous self-harm, psychiatric treatment, employment status, marital status) and one area-based factor (proportion of individuals of white ethnicity) as being independently associated with individual repetition. The population attributable fraction (an indicator of the potential population impact) for these variables was 79%. Conclusion: The repetition of self-harm may be more strongly related to individual factors than to the characteristics of the areas in which people live. We need to better understand the processes underlying ecological associations with suicidal behaviour before embarking on area-based interventions.

Language: en