Increasing rates of self-harm among children, adolescents and young adults: a 10-year national registry study 2007–2016

Griffin, Eve; McMahon, Elaine M.; McNicholas, Fiona; Corcoran, Paul; Perry, Ivan J.; Arensman, Ella

doi:10.1007/s00127-018-1522-1

Cited by 147 publications

(112 citation statements)

References 38 publications

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“…In Ireland, increases in ED self-harm rates between 2007 and 2016 were particularly pronounced among girls aged 10-19 [5]. Similarly, in the UK, self-harm incidence rates in GP-registered patient cohort increased only in younger teenage girls aged 13-16, with this group also having the highest rates of all age and sex groups [13].…”

Section: Interpretation and Comparison With Existing Evidencementioning

confidence: 95%

“…Rates of hospital-treated self-harm have been found to be particularly raised in adolescents compared to older age groups. Studies examining emergency department (ED) visits in Western countries (including Ireland, the US, Denmark and the UK) have found the highest rates of self-harm among girls aged between 15 and 19 years [5][6][7][8][9]. A substantial body of evidence indicates that economic recession and its aftermath is associated with increases in rates of suicide and self-harm, though much of this work focuses on the working-age population [10][11][12].…”

Section: Introductionmentioning

confidence: 99%

“…A substantial body of evidence indicates that economic recession and its aftermath is associated with increases in rates of suicide and self-harm, though much of this work focuses on the working-age population [10][11][12]. Evidence from a study of ED presentations in Ireland [5] and also from a primary care patient cohort in the UK [13] indicate that self-harm incidence rates among adolescent females increased from around the time of the 2008 economic recession and through the era of subsequent austerity measures. Similarly, rates of ED presentation following self-harm and mental health concerns both increased rapidly among adolescents between 2009 and 2017 in Ontario, Canada, with particularly pronounced increases seen in girls [14].…”

Section: Introductionmentioning

confidence: 99%

“…Poisonings are the most common method of hospitalpresenting self-harm in the UK, Ireland and Denmark [5,7,9], but self-injury is the more common type of self-harm in the community [7]. A recently published study examined prevalence of non-suicidal self-injury in England, regardless as to whether treatment was sought [17].…”

Section: Introductionmentioning

confidence: 99%

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Temporal trends in incidence of hospital-treated self-harm among adolescents in Denmark: national register-based study

Steeg

Carr

Mok

et al. 2019

Soc Psychiatry Psychiatr Epidemiol

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Background Studies conducted in the UK and in Ireland have reported increased rates of self-harm in adolescent females from around the time of the 2008 economic recession and through periods of subsequent national austerity programme implementation. It is not known if incidence rates have increased similarly in other Western European countries during this period. Methods Data from interlinked national administrative registers were extracted for individuals born in Denmark during 1981-2006. We estimated gender-and age-specific incidence rates (IRs) per 10,000 person-years at risk for hospital-treated non-fatal self-harm during 2000-2016 at ages 10-19 years. Results Incidence of self-harm peaked in 2007 (IR 25.1) and then decreased consistently year on year to 13.8 in 2016. This pattern was found in all age groups, in both males and females and in each parental income tertile. During the last 6 years of the observation period, 2011-2016, girls aged 13-16 had the highest incidence rates whereas, among boys, incidence was highest among 17-19 year olds throughout. Conclusions The temporal increases in incidence rates of self-harm among adolescents observed in some Western European countries experiencing major economic recession were not observed in Denmark. Restrictions to sales of analgesics, access to dedicated suicide prevention clinics, higher levels of social spending and a stronger welfare system may have protected potentially vulnerable adolescents from the increases seen in other countries. A better understanding of the specific mechanisms behind the temporal patterns in self-harm incidence in Denmark is needed to help inform suicide prevention in other nations.

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Section: Interpretation and Comparison With Existing Evidencementioning

confidence: 95%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Temporal trends in incidence of hospital-treated self-harm among adolescents in Denmark: national register-based study

Steeg

Carr

Mok

et al. 2019

Soc Psychiatry Psychiatr Epidemiol

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“…In most other studies, NSSH was amalgamated with suicide attempts. [6][7][8][9] Analyses of Danish hospital registration data for 1994-2011, for example, showed a rising frequency of self-harm (with and without suicidal intent) in both sexes, with the greatest increases in women and girls aged 15-24 years. 9 Data from the National Self-Harm Registry in Ireland showed that the frequency of selfharm increased by 22% between 2007 and 2016 in 10-24-year-olds, and by more in women and girls.…”

Section: Introductionmentioning

confidence: 99%

Prevalence of non-suicidal self-harm and service contact in England, 2000–14: repeated cross-sectional surveys of the general population

McManus¹,

Gunnell

Cooper

et al. 2019

The Lancet Psychiatry

314

241

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Background The number of people presenting to hospital emergency departments after self-harming has increased in England. However, most people who self-harm do not present to hospitals, so whether this rise reflects an increase in the prevalence of self-harm in the community is unknown. Also unknown is whether the prevalence of nonsuicidal self-harm (NSSH) or suicidal self-harm, or both, has increased. We aimed to establish temporal trends in the prevalence of NSSH in England. Methods We analysed data from participants in the 2000 (n=7243), 2007 (n=6444), and 2014 (n=6477) Adult Psychiatric Morbidity Surveys of the general population, selecting those aged 16-74 years and living in England. We used weighted data and controlled for complex survey design. We generated temporal trends in lifetime prevalence and methods of, and motivations for, NSSH, and consequent service contact. We used multiple variable logistic regression analyses to investigate factors associated with service contact. Findings The prevalence of self-reported lifetime NSSH increased from 2•4% (95% CI 2•0-2•8) in 2000, to 6•4% (5•8-7•2) in 2014. Increases in prevalence were noted in both sexes and across age groups-most notably in women and girls aged 16-24 years, in whom prevalence increased from 6•5% (4•2-10•0) in 2000, to 19•7% (15•7-24•5) in 2014. The proportion of the population reporting NSSH to relieve unpleasant feelings of anger, tension, anxiety, or depression increased from 1•4% (95% CI 1•0-2•0) to 4•0% (3•2-5•0) in men and boys, and from 2•1% (1•6-2•7) to 6•8% (6•0-7•8) in women and girls, between 2000 and 2014. In 2014, 59•4% (95% CI 54•7-63•9) of participants who had engaged in NSSH reported no consequent medical or psychological service contact, compared with 51•2% (42•2-60•0) in 2000 and 51•8% (47•3-56•4) in 2007. Male participants and those aged 16-34 years were less likely to have contact with health services than were female participants and older people. Interpretation The prevalence of NSSH has increased in England, but resultant service contact remains low. In 2014, about one in five female 16-24-year-olds reported NSSH. There are potential lifelong implications of NSSH, such as an increased frequency of suicide, especially if the behaviours are adopted as a long-term coping strategy. Self-harm needs to be discussed with young people without normalising it. Young people should be offered help by primary care, educational, and other services to find safer ways to deal with emotional stress.

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Assessment of Somatosensory Function and Self-harm in Adolescents

et al. 2021

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IMPORTANCE Self-harm is a risk factor for suicide in adolescents, with the prevalence highest in young people in group and residential care programs. Although no established risk factors for selfharm exist, adolescents who self-harm may have decreased pain sensitivity, but this has not been systematically investigated.OBJECTIVE To assess somatosensory function using quantitative sensory testing (QST) in children and adolescents living in care grouped by the number of episodes of self-harm in the past year and compare their somatosensory profiles with community control participants to investigate associations with the incidence or frequency of self-harm. DESIGN, SETTING, AND PARTICIPANTSRecruitment for this cross-sectional study began January 2019 and ended March 2020. Exclusion criteria included intellectual disability (intelligence quotient <70), autism spectrum disorder, or recent serious injury. Children and adolescents aged 12 to 17 years with no underlying health conditions were recruited from local authority residential care settings in Glasgow, UK, and schools and youth groups in London and Glasgow, UK. The volunteer sample of 64 participants included adolescents ages 13 to 17 years (34 [53%] females; 50 [78%] living in residential care; mean [SD] age, 16.34 [1.01] years) with varying incidents of self-harm in the past year (no episodes, 31 [48%]; 1-4 episodes, 12 [19%]; and Ն5 episodes, 2 [33%]). EXPOSURES Participants were tested using a standardized QST protocol to establish baseline somatosensory function. MAIN OUTCOMES AND MEASURES Associations between somatosensory sensitivity, incidence and frequency of self-harm, residential status, age, gender, and prescription medication were calculated. Secondary outcomes assessed whether self-harm was associated with specific types of tests (ie, painful or nonpainful). RESULTS A total of 64 participants ages 13 to 17 years completed testing (mean [SD] age, 16.3 [1.0] years; 34 [53%.] females and 30 [47%] males; 50 [78%] living in group homes). Adolescents with 5or more self-harm incidences showed significant pain hyposensitivity compared with community control participants after adjusting for age, gender, and prescription drug use (SH group with 5 or more episodes vs control: −1.03 [95% CI, −1.47 to −0.60]; P < .001). Hyposensitivity also extended to nonpainful stimuli, similarly adjusted (SH group with 5 or more episodes vs control: −1.73; 95% CI, −2.62 to −0.84; P < .001). Pressure pain threshold accounted for most of the observed variance (31.1% [95% CI, 10.5% to 44.7%]; P < .001). CONCLUSIONS AND RELEVANCEThe findings of this study suggest that sensory hyposensitivity is a phenotype of Adolescents who self-harm and that pressure pain threshold has clinical potential as (continued)

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Increasing rates of self-harm among children, adolescents and young adults: a 10-year national registry study 2007–2016

Abstract: The findings indicate that the age of onset of self-harm is decreasing. Increasing rates of self-harm, along with increases in highly lethal methods, indicate that targeted interventions in key transition stages for young people are warranted.

Cited by 147 publications

References 38 publications

Temporal trends in incidence of hospital-treated self-harm among adolescents in Denmark: national register-based study

Temporal trends in incidence of hospital-treated self-harm among adolescents in Denmark: national register-based study

Prevalence of non-suicidal self-harm and service contact in England, 2000–14: repeated cross-sectional surveys of the general population

Assessment of Somatosensory Function and Self-harm in Adolescents

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