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

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dc.contributor.author Cully, Grace
dc.contributor.author Corcoran, Paul
dc.contributor.author Leahy, Dorothy
dc.contributor.author Griffin, Eve
dc.contributor.author Shiely, Frances
dc.contributor.author Arensman, Ella
dc.date.accessioned 2018-12-17T15:57:16Z
dc.date.available 2018-12-17T15:57:16Z
dc.date.issued 2018-11-29
dc.identifier.citation 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 en
dc.identifier.startpage 1 en
dc.identifier.endpage 24 en
dc.identifier.issn 0165-0327
dc.identifier.uri http://hdl.handle.net/10468/7233
dc.identifier.doi 10.1016/j.jad.2018.10.372
dc.description.abstract 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. en
dc.description.sponsorship Irish Health Research Board (grant number: IRRL-2015-1586); Irish Health Service Executive (National Self-Harm Registry Ireland, funded by the Irish Health Service Executive's National Office for Suicide Prevention) en
dc.format.mimetype application/pdf en
dc.language.iso en en
dc.publisher Elsevier en
dc.relation.uri http://www.sciencedirect.com/science/article/pii/S0165032718312965
dc.rights © 2018 Published by Elsevier B.V. All rights reserved. This manuscript version is made available under the CC-BY-NC-ND 4.0 license en
dc.subject Self-harm en
dc.subject Self-harm method en
dc.subject Self-harm repetition en
dc.subject Risk factor en
dc.subject Risk assessment en
dc.subject Mental health en
dc.title Method of self-harm and risk of self-harm repetition: findings from a national self-harm registry en
dc.type Article (peer-reviewed) en
dc.internal.authorcontactother Grace Cully, School of Public Health, University College Cork, Cork, Ireland. +353-21-490-3000 Email: grace.cully@ucc.ie en
dc.internal.availability Full text available en
dc.check.info Access to this article is restricted until 12 months after publication by request of the publisher. en
dc.check.date 2019-11-29
dc.date.updated 2018-12-17T15:43:41Z
dc.description.version Accepted Version en
dc.internal.rssid 465912066
dc.contributor.funder Health Research Board en
dc.description.status Peer reviewed en
dc.identifier.journaltitle Journal of Affective Disorders en
dc.internal.copyrightchecked No !!CORA!! en
dc.internal.licenseacceptance Yes en
dc.internal.IRISemailaddress grace.cully@ucc.ie en


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