Risk factors for repetition of self-harm: a systematic review of prospective hospital-based studies

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dc.contributor.authorLarkin, Celine
dc.contributor.authorDi Blasi, Zelda
dc.contributor.authorArensman, Ella
dc.contributor.funderHealth Research Board
dc.contributor.funderNational Office for Suicide Prevention, Ireland
dc.date.accessioned2016-02-17T11:44:41Z
dc.date.available2016-02-17T11:44:41Z
dc.date.issued2014
dc.description.abstractBackground: Self-harm entails high costs to individuals and society in terms of suicide risk, morbidity and healthcare expenditure. Repetition of self-harm confers yet higher risk of suicide and risk assessment of self-harm patients forms a key component of the health care management of self-harm patients. To date, there has been no systematic review published which synthesises the extensive evidence on risk factors for repetition. Objective: This review is intended to identify risk factors for prospective repetition of self-harm after an index self-harm presentation, irrespective of suicidal intent. Data sources: PubMed, PsychInfo and Scirus were used to search for relevant publications. We included cohort studies which examining factors associated with prospective repetition among those presenting with self-harm to emergency departments. Journal articles, abstracts, letters and theses in any language published up to June 2012 were considered. Studies were quality-assessed and synthesised in narrative form. Results: A total of 129 studies, including 329,001 participants, met our inclusion criteria. Some factors were studied extensively and were found to have a consistent association with repetition. These included previous self-harm, personality disorder, hopelessness, history of psychiatric treatment, schizophrenia, alcohol abuse/dependence, drug abuse/dependence, and living alone. However, the sensitivity values of these measures varied greatly across studies. Psychological risk factors and protective factors have been relatively under-researched but show emerging associations with repetition. Composite risk scales tended to have high sensitivity but poor specificity. Conclusions: Many risk factors for repetition of self-harm match risk factors for initiation of self-harm, but the most consistent evidence for increased risk of repetition comes from long-standing psychosocial vulnerabilities, rather than characteristics of an index episode. The current review will enhance prediction of self-harm and assist in the efficient allocation of intervention resources.en
dc.description.sponsorshipHealth Research Board (PhD in Health Services Research)en
dc.description.statusPeer revieweden
dc.description.versionPublished Versionen
dc.format.mimetypeapplication/pdfen
dc.identifier.articleide84282
dc.identifier.citationLarkin C, Di Blasi Z, Arensman E (2014) Risk Factors for Repetition of Self-Harm: A Systematic Review of Prospective Hospital-Based Studies. PLoS ONE 9(1): e84282. doi:10.1371/journal.pone.0084282
dc.identifier.doi10.1371/journal.pone.0084282
dc.identifier.issn1932-6203
dc.identifier.issued1en
dc.identifier.journaltitlePLOS ONEen
dc.identifier.urihttps://hdl.handle.net/10468/2345
dc.identifier.volume9en
dc.language.isoenen
dc.publisherPublic Library of Scienceen
dc.rights© 2015 Larkin et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are crediteden
dc.rights.urihttp://creativecommons.org/licenses/by/4.0/en
dc.subjectTerm follow-upen
dc.subjectSubsequent suicidal behavioren
dc.subjectEmergency departmenten
dc.subjectParasuicide repetitionen
dc.subjectMulticenter cohorten
dc.subjectPredictive scalesen
dc.subjectDeliberateen
dc.subjectAttemptersen
dc.subjectRepeaten
dc.subjectEpidemiologyen
dc.subject~Applied Psychology - Journal Articles~en
dc.titleRisk factors for repetition of self-harm: a systematic review of prospective hospital-based studiesen
dc.typeArticle (peer-reviewed)en
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