Epidemiology and trends in non-fatal self-harm in three centres in England, 2000–2012: findings from the Multicentre Study of Self-harm in England

Abstract

ObjectivesSelf-harm is a major health problem in many countries, with potential adverse outcomes including suicide and other causes of premature death. It is important to monitor national trends in this behaviour. We examined trends in non-fatal self-harm and its management in England during the 13-year period, 2000–2012.Design and settingThis observational study was undertaken in the three centres of the Multicentre Study of Self-harm in England. Information on all episodes of self-harm by individuals aged 15 years and over presenting to five general hospitals in three cities (Oxford, Manchester and Derby) was collected through face-to-face assessment or scrutiny of emergency department electronic databases. We used negative binomial regression models to assess trends in rates of self-harm and logistic regression models for binary outcomes (eg, assessed vs non-assessed patients).ParticipantsDuring 2000–2012, there were 84 378 self-harm episodes (58.6% by females), involving 47 048 persons.ResultsRates of self-harm declined in females (incidence rate ratio (IRR) 0.98; 95% CI 0.97 to 0.99, p<0.0001). In males, rates of self-harm declined until 2008 (IRR 0.96; 95% CI 0.95 to 0.98, p<0.0001) and then increased (IRR 1.05; 95% CI 1.02 to 1.09, p=0.002). Rates of self-harm were strongly correlated with suicide rates in England in males (r=0.82, p=0.0006) and females (r=0.74, p=0.004). Over 75% of self-harm episodes were due to self-poisoning, mainly with analgesics (45.7%), antidepressants (24.7%) and benzodiazepines (13.8%). A substantial increase in self-injury occurred in the latter part of the study period. This was especially marked for self-cutting/stabbing and hanging/asphyxiation. Psychosocial assessment by specialist mental health staff occurred in 53.2% of episodes.ConclusionsTrends in rates of self-harm and suicide may be closely related; therefore, self-harm can be a useful mental health indicator. Despite national guidance, many patients still do not receive psychosocial assessment, especially those who self-injure.

Incidence, clinical management, and mortality risk following self harm among children and adolescents: cohort study in primary care

“…25 Recent data from the adult psychiatric morbidity survey in England, 28 based on clinical interviews, indicate that 11.7% of [16][17][18][19][20][21][22][23][24] year old females in 2007 reported ever self harming, increasing to 19.7% in 2014. In a multicentre hospital based study in England, 26 age standardised incidence of self harm appeared to decline from 2000 until 2009, with a possible increase and stabilising of rates from 2009 to 2012, although figures were based on a combined age range of 15-24 years. The trends reported in our study are consistent with the observed increase in psychological distress among adolescent girls 29 and the increase in suicide rates in England in females aged 10-29 years, of 2.7 per 100 000 in 2012 to 3.2 per 100 000 in 2015.…”

Spatial patterning of self-harm rates within urban areas

“…Likewise, suicide rates, which tend to follow trends in self-harm rates [2], have fallen in inner London, a change that is not explained by changes in employment or social fragmentation [16]. Such variation within urban areas remains unexplained.…”

Le suicide et les hospitalisations associées à des blessures auto-infligées au Canada (1979 à 2014-2015)

“…20,21,37 , il ressort de cette étude que l'intoxication est la méthode la plus cou rante associée aux hospitalisations pour blessures autoinfligées, tant chez les hom mes que chez les femmes. Par ailleurs, il a été observé que la suffocation était la principale méthode de suicide chez les deux sexes, suivie de l'intoxication chez les femmes et à la fois de l'intoxication et des armes à feu chez les hommes.…”