Risk of repeated self-harm and associated factors in children, adolescents and young adults

dc.contributor.authorMcMahon, Elaine M.
dc.contributor.authorCorcoran, Paul
dc.contributor.authorBennardi, Marco
dc.contributor.authorGriffin, Eve
dc.contributor.authorArensman, Ella
dc.contributor.funderSeventh Framework Programmeen
dc.description.abstractBackground: Repeated self-harm represents the single strongest risk factor for suicide. To date no study with full national coverage has examined the pattern of hospital repeated presentations due to self-harm among young people. Methods: Data on consecutive self-harm presentations were obtained from the National Self-Harm Registry Ireland. Socio-demographic and behavioural characteristics of individuals aged 10–29 years who presented with self-harm to emergency departments in Ireland (2007–2014) were analysed. Risk of long-term repetition was assessed using survival analysis and time differences between the order of presentations using generalised estimating equation analysis. Results: The total sample comprised 28,700 individuals involving 42,642 presentations. Intentional drug overdose was the most prevalent method (57.9%). Repetition of self-harm occurred in 19.2% of individuals during the first year following a first presentation, of whom the majority (62.7%) engaged in one repeated act. Overall, the risk of repeated self-harm was similar between males and females. However, in the 20–24-year-old age group males were at higher risk than females. Those who used self-cutting were at higher risk for repetition than those who used intentional drug overdose, particularly among females. Age was associated with repetition only among females, in particular adolescents (15–19 years old) were at higher risk than young emerging adults (20–24 years old). Repeated self-harm risk increased significantly with the number of previous self-harm episodes. Time differences between first self-harm presentations were detected. Time between second and third presentation increased compared to time between first and second presentation among low frequency repeaters (patients with 3 presentations only within 1 year following a first presentation). The same time period decreased among high frequency repeaters (patients with at least 4 to more than 30 presentations). Conclusion: Young people with the highest risk for repeated self-harm were 15–19-year-old females and 20–24-year-old males. Self-cutting was the method associated with the highest risk of self-harm repetition. Time between first self-harm presentations represents an indicator of subsequent repetition. To prevent risk of repeated self-harm in young people, all individuals presenting at emergency departments due to self-harm should be provided with a risk assessment including psychosocial characteristics, history of self-harm and time between first presentations.en
dc.description.statusPeer revieweden
dc.description.versionPublished Versionen
dc.identifier.citationBennardi, M., McMahon, E., Corcoran, P., Griffin, E. and Arensman, E. (2016) 'Risk of repeated self-harm and associated factors in children, adolescents and young adults', BMC Psychiatry, 16:421 (12pp). doi:10.1186/s12888-016-1120-2en
dc.identifier.journaltitleBMC Psychiatryen
dc.publisherBioMed Centralen
dc.relation.projectinfo:eu-repo/grantAgreement/EC/FP7::SP3::PEOPLE/316795/EU/Mental Health Training through Research Network in Europe/MARATONEen
dc.rights© 2016, the Authors. Open Access. This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.en
dc.subjectRepeated self-harmen
dc.subjectYoung peopleen
dc.subjectEmergency departmentsen
dc.subjectSelf-harm methodsen
dc.titleRisk of repeated self-harm and associated factors in children, adolescents and young adultsen
dc.typeArticle (peer-reviewed)en
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