Citation

Cooper J, Dunning J, Guthrie E, Mackway-Jones K, Appleby L, Kapur N. Psychiatr. Danub. 2006; 18(Suppl 1): 55.

Affiliation

University of Manchester, Oxford Road, M13 9PL Manchester, United Kingdom. jayne.cooper@manchester.ac.uk.

Copyright

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

DOI

unavailable

PMID

16963940

Abstract

Objective: Development of a risk stratification model for use by Emergency Department clinical staff in the assessment of patients attending with self-harm. Methods: Participants were treated patients who attended five Emergency Departments in the largely urban areas of Manchester and Salford, UK following self-harm between 1st September 1997 and 28th February 2001. Social, demographic and clinical information were collected for each patient at each attendance. Using this data, a clinical decision rule was derived using recursive partitioning to discriminate between patients at higher and lower risk of repetition or subsequent suicide occurring within 6 months. Data from three Emergency Departments were used for the derivation set. The model was validated using data from the remaining two Emergency Departments. Results: Data on 9086 patients who presented with self-harm were collected, including 16.8% that reattended within 6 months and 15 patients who died by suicide within 6 months. A four question rule, with a sensitivity of 94% and specificity of 25%, was derived to identify patients at higher risk of repetition or suicide. Conclusions: Application of this simple, highly sensitive rule may facilitate assessment in the Emergency Department and help to focus psychiatric resources on patients at higher risk.

Language: en