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

Cully, Grace; Corcoran, Paul; Leahy, Dorothy; Griffin, Eve; Shiely, Frances; Arensman, Ella

Access to this article is restricted until 12 months after publication by request of the publisher.. Restriction lift date: 2019-11-29

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

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dc.check.date	2019-11-29
dc.check.info	Access to this article is restricted until 12 months after publication by request of the publisher.	en
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.contributor.funder	Health Research Board	en
dc.date.accessioned	2018-12-17T15:57:16Z
dc.date.available	2018-12-17T15:57:16Z
dc.date.issued	2018-11-29
dc.date.updated	2018-12-17T15:43:41Z
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.description.status	Peer reviewed	en
dc.description.version	Accepted Version	en
dc.format.mimetype	application/pdf	en
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.doi	10.1016/j.jad.2018.10.372
dc.identifier.endpage	24	en
dc.identifier.issn	0165-0327
dc.identifier.journaltitle	Journal of Affective Disorders	en
dc.identifier.startpage	1	en
dc.identifier.uri	https://hdl.handle.net/10468/7233
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.rights.uri	https://creativecommons.org/licenses/by-nc-nd/4.0/
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