Fatal and non-fatal repetition of self-harm

Owens, David; Horrocks, Judith; House, Allan

doi:10.1192/bjp.181.3.193

Cited by 1,101 publications

(874 citation statements)

References 88 publications

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“…For instance, the SADPERSONS tool, a risk assessment based on recognised demographic and clinical factors, does not predict individuals requiring psychiatric admission or community aftercare, or those who repeat self-harm (Quinlivan et al, 2016;Saunders et al, 2014). Currently, the most important predictor of future self-harm and suicide is past self-harm Owens et al, 2002). However, most people who self-harmed will not reattempt and will not die by suicide (Owens et al, 2002).…”

Section: What Do We Currently Understand Predicts Self-harm and Repetmentioning

confidence: 99%

“…Currently, the most important predictor of future self-harm and suicide is past self-harm Owens et al, 2002). However, most people who self-harmed will not reattempt and will not die by suicide (Owens et al, 2002). Therefore, the predictive value of clinical and demographic parameters alone is weak, and in light of the increasing incidence of suicide, assessment using additional factors is required to accurately predict future self-harm.…”

Section: What Do We Currently Understand Predicts Self-harm and Repetmentioning

confidence: 99%

“…Some may argue that NSSI is not related to suicide attempts, especially in the United States where NSSI has been segregated from "suicidal behaviour syndrome" in the new DSM-5 (APA, 2015). However, the majority of the evidence indicates that any form of self-harm, regardless of intent, increases the risk of future self-harm and suicide (Brent, 2011;Groschwitz et al, 2015;Owens et al, 2002;Wilkinson et al, 2011).…”

Section: Strengths and Limitations Of This Systematic Reviewmentioning

confidence: 99%

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Are neurocognitive factors associated with repetition of self-harm? A systematic review

Cates

Rees

Jollant

et al. 2017

Neuroscience & Biobehavioral Reviews

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Background:Prediction of self-harm is limited clinically. Early identification of individuals likely to repeat self-harm could improve outcomes and reduce suicide risk. Various neurocognitive deficits have been found in people who self-harm, but the ability of these to predict repetition has yet to be established Aims:Identify neurocognitive factors that may predict repetition of self-harm. Methods:Systematic narrative review of English language publications assessing neurocognitive functioning and self-harm repetition, searching multiple databases from inception to March 2015. Quality of studies was appraised. A narrative synthesis was performed. Results:7026 unique records were identified, and 169 full-texts assessed. 15 unique studies provided data. No imaging studies could be included. Most studies assessed cognitive control or problem solving, but neither factor was consistently associated with repetition. However, specific tasks may show promise. Two studies in adolescents suggest that value-based decision-making impairments could be predictive of repetition. There were too few results for memory to draw specific conclusions. Conclusions:Selected studies suggest promise for particular neurocognitive factors and specific cognitive tasks in terms of repetition of self-harm.

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Section: What Do We Currently Understand Predicts Self-harm and Repetmentioning

confidence: 99%

Section: What Do We Currently Understand Predicts Self-harm and Repetmentioning

confidence: 99%

Section: Strengths and Limitations Of This Systematic Reviewmentioning

confidence: 99%

See 1 more Smart Citation

Are neurocognitive factors associated with repetition of self-harm? A systematic review

Cates

Rees

Jollant

et al. 2017

Neuroscience & Biobehavioral Reviews

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“…Although around 60 times greater than the population rate, in the UK the incidence is probably somewhere in the region of one in a hundred patients within the first year (Owens et al, 2002;Carroll et al, 2014). But the risk is far higher in certain subgroups and goes on rising over many years after an index episode of non-fatal self-harm.…”

Section: Resultsmentioning

confidence: 97%

Combination of self-harm methods and fatal and non-fatal repetition: A cohort study

Birtwistle

Kelley

House

et al. 2017

Journal of Affective Disorders

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“…3 Although suicidal intent is considered low for children and adolescents 4 and the long-term risk of death by suicide after a self-harm event is similarly low (approximately 1% at 10 years), 4,5 visits to the emergency department (ED) for self-harm may be more strongly associated with the intent to die. [5][6][7] A recently published Canadian study found that only 1 in 3 adolescents in Ontario who presented to the ED for self-harm were admitted to hospital. 8 While discharge can be considered for children and adolescents who are not actively suicidal, do not have access to lethal means, and have a responsible adult to ensure their safety, post-ED visit mental health care follow-up should be in place.…”

Section: Introductionmentioning

confidence: 99%

Emergency Health Care Use among Sociodemographic Groups of Children Presenting to Emergency Departments for Self-Harm in Alberta

Newton

Tsang

Rosychuk

2015

CJEM

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Objective: To examine sociodemographic variations among children <18 years in (1) rates of self-harm visits to emergency departments (EDs) and (2) physician follow-up after the selfharm visit in Alberta. Methods: A retrospective, population-based cohort (2002)(2003)(2004)(2005)(2006)(2007)(2008)(2009)(2010)(2011) of ED visits for self-harm by individuals <18 years was conducted using administrative databases from Alberta, Canada. Individuals were grouped by First Nations status or type of health care premium subsidy (family receipt of government subsidy, human services program subsidy, no subsidy received). Visits from 104 EDs were summarized by crude and directly standardized visit rates (DSVRs) per 100,000 individuals. Kaplan-Meier estimates for median estimated time to physician follow-up were calculated with 95% confidence intervals (CIs). Results: During the study period, visit rates decreased with the exception of children from families receiving government-sponsored program subsidy (DSVRs 163/ 100,000 to 250/100,000; p = 0.032). First Nations children had disproportionately fewer follow-up visits compared to other children. The median time to follow-up for First Nations children was 39 days (95% CI: 32, 48) compared to 16 days for children from families receiving no subsidy (95% CI: 14, 19), who had the shortest follow-up time after an ED visit. Conclusions: Sociodemographic differences were evident in ED visit rates as well as the number of and time to physician followup visit. The disparities experienced by First Nations children in the follow-up period highlight an opportunity for culturallygrounded risk and needs assessment in the ED to determine and facilitate timely and appropriate follow-up care.

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Fatal and non-fatal repetition of self-harm

Abstract: After 1 year, non-fatal repetition rates are around 15%. The strong connection between self-harm and later suicide lies somewhere between 0.5% and 2% after 1 year and above 5% after 9 years. Suicide risk among self-harm patients is hundreds of times higher than in the general population.

Cited by 1,101 publications

References 88 publications

Are neurocognitive factors associated with repetition of self-harm? A systematic review

Are neurocognitive factors associated with repetition of self-harm? A systematic review

Combination of self-harm methods and fatal and non-fatal repetition: A cohort study

Emergency Health Care Use among Sociodemographic Groups of Children Presenting to Emergency Departments for Self-Harm in Alberta

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