TY - JOUR PY - 2019// TI - Method of self-harm and risk of self-harm repetition: findings from a national self-harm registry JO - Journal of affective disorders A1 - Cully, G. A1 - Corcoran, P. A1 - Leahy, D. A1 - Griffin, E. A1 - Dillon, C. A1 - Cassidy, E. A1 - Shiely, F. A1 - Arensman, E. SP - 843 EP - 850 VL - 246 IS - N2 - BACKGROUND: Risk of self-harm repetition has consistently been shown to be higher following self-cutting compared to intentional drug overdose (IDO) and other self-harm methods. The utility of previous evidence is limited due to the large heterogeneous method categories studied. This study examined risk of hospital presented self-harm repetition according to specific characteristics of self-harm methods.

METHODS: Data on consecutive self-harm presentations to hospital emergency departments (2010-2016) were obtained from the National Self-Harm Registry Ireland. Associations between self-harm method and repetition were analysed using survival analyses.

RESULTS: Overall, 65,690 self-harm presentations were made involving 46,661 individuals. Self-harm methods associated with increased repetition risk included minor self-cutting, severe self-cutting, multiple drug IDOs involving psychotropic drugs and self-harm by blunt object. Minor self-cutting was the method associated with highest repetition risk (adjusted hazard ratio (AHR) 1.38, 95% CI 1.31-1.45). Risk of repetition was comparable following IDOs of four or more drugs involving psychotropic drugs (AHR = 1.29, 95% CI 1.20-1.39), severe self-cutting (AHR 1.25, 95% CI 1.16-1.34) and blunt object (AHR = 1.23, 95% CI 1.07-1.42). LIMITATIONS: Information was not available on suicide or other causes of mortality.

CONCLUSIONS: Self-harm method and the associated risk of repetition should form a core part of biopsychosocial assessments and should inform follow-up care for self-harm patients. The observed differences in repetition associated with specific characteristics of IDO underline the importance of safety planning and monitoring prescribing for people who have engaged in IDO.

Copyright © 2018. Published by Elsevier B.V.

Language: en

LA - en SN - 0165-0327 UR - http://dx.doi.org/10.1016/j.jad.2018.10.372 ID - ref1 ER -