Method of self-harm and risk of self-harm repetition: findings from a national self-harm registry

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Cully, Grace
Corcoran, Paul
Leahy, Dorothy
Griffin, Eve
Shiely, Frances
Arensman, Ella
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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.
Self-harm , Self-harm method , Self-harm repetition , Risk factor , Risk assessment , Mental health
Cully, G., Corcoran, P., Leahy, D., Griffin, E., Dillon, C., Cassidy, E., Shiely, F. and Arensman, E. (2018) 'Method of self-harm and risk of self-harm repetition: findings from a national self-harm registry', Journal of Affective Disorders, In Press, doi: 10.1016/j.jad.2018.10.372
© 2018 Published by Elsevier B.V. All rights reserved. This manuscript version is made available under the CC-BY-NC-ND 4.0 license