Epidemiological profile of repeated self-harm presentations to healthcare services in a Brazilian urban centre (Vitoria, ES)

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dc.contributor.authorKavalidou, Katerinaen
dc.contributor.authorPredo, Renata Martinsen
dc.contributor.authorde Oliveira, Vítor Fabrien
dc.contributor.authorIglesias, Alexandraen
dc.contributor.authorDimenstein, Magda Dinizen
dc.contributor.authorCosta, Raísa Catherinne Cagliarien
dc.contributor.authorZortea, Tiago C.en
dc.date.accessioned2026-08-12T14:59:45Z
dc.date.available2026-08-12T14:59:45Z
dc.date.issued2026-07-01en
dc.description.abstractAbstract: Background: In Brazil, national surveillance indicates a rise in self-harm, but little is known about patterns of repeated presentations to healthcare services or changes in self-harm methods over time. Aims: To examine sociodemographic and clinical factors associated with two or more (repeated) presentations to healthcare services for self-harm, and to explore method switching among individuals presenting to healthcare services in Vitória, Brazil. Method: A retrospective cohort analysis was conducted using administrative data from the Brazilian Unified Health System in Vitoria City (Espírito Santo; 2012–2022). Records from the Notifiable Diseases Information System and e-SUS National Health Surveillance System were used to identify individuals with self-harm presentations. Modified Poisson Regression was employed to examine associations between repeated self-harm episodes and sociodemographic and clinical characteristics between 2018 and 2022. Results: Among 2,152 self-harm notifications, 69% involved repeated presentations. The results revealed that female sex [RR = 1.14, 95% CI: 1.06–1.23], presence of disorder [RR = 1.41, 95% CI: 1.27–1.57], and use of sharp objects [RR = 1.22, 95% CI: 1.12–1.32] were positively associated with repetition, whereas Black [RR = 0.87, 95% CI: 0.79–0.95], multiracial ethnicity [RR = 0.92, 95% CI: 0.87–0.98], and poisoning [RR = 0.92, 95% CI: 0.85–1.00] were negatively associated. Among those with multiple episodes, half re-presented within 77 days and three-quarters within 260 days. Method switching was common: 42% changed methods between their first and second episodes, with cutting most frequently transitioning to self-poisoning. Limitations: Findings rely on routine notification data, which vary in completeness. Some clinical information was based on collateral reports rather than diagnosis. Conclusion: Repeated self-harm presentations often occur within short intervals. High levels of method switching underscore the need for person-centered assessments.en
dc.description.statusPeer revieweden
dc.description.versionAccepted Versionen
dc.format.mimetypeapplication/pdfen
dc.identifier.articleid10.1027/0227-5910/a001066en
dc.identifier.citationKavalidou, K., Predo, R. M., de Oliveira, V. F., Iglesias, A., Dimenstein, M. D., Costa, R. C. C. and Zortea, T. C. (2026) 'Epidemiological profile of repeated self-harm presentations to healthcare services in a Brazilian urban centre (Vitoria, ES)', Crisis: The Journal of Crisis Intervention and Suicide Prevention, 47(4), pp. 260-271. https://doi.org/10.1027/0227-5910/a001066en
dc.identifier.doi10.1027/0227-5910/a001066en
dc.identifier.endpage271en
dc.identifier.issn0227-5910en
dc.identifier.issn2151-2396en
dc.identifier.issued4en
dc.identifier.journaltitleCrisisen
dc.identifier.startpage260en
dc.identifier.urihttps://hdl.handle.net/10468/19116
dc.identifier.volume47en
dc.language.isoenen
dc.publisherHogrefe Publishing Groupen
dc.rights© 2026, Hogrefe Publishing Group. This version of the article may not completely replicate the final authoritative version published in Crisis at https://doi.org/10.1027/0227-5910/a001066. It is not the version of record and is therefore not suitable for citation.en
dc.rights.urihttps://creativecommons.org/licenses/by/4.0/en
dc.subjectSelf-harmen
dc.subjectRepetitionen
dc.subjectBrazilen
dc.subjectVitoriaen
dc.subjectPublic health dataen
dc.titleEpidemiological profile of repeated self-harm presentations to healthcare services in a Brazilian urban centre (Vitoria, ES)en
dc.typeArticle (peer-reviewed)en
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