Repetition of Suicidal Behaviour

The efficacy of problem-solving treatments after deliberate self-harm: meta-analysis of randomized controlled trials with respect to depression, hopelessness and improvement in problems

“…The main difference was in the proportion of those who were repeaters of DSH at the time of entry to the trial, this varying between nearly a third ) and all patients (Salkovskis et al 1990 ;Evans et al 1999), although this information was not provided in two trials. Repeaters are generally more difficult to treat effectively (Sakinofsky, 2000) so the main likely effect of this variation would have been to reduce treatment effects in those studies which included a greater proportion of individuals with previous DSH. In fact, there was no indication of this being so.…”

“…In treatment trials of DSH it is important to assess repetition of DSH as an outcome because it is common (Bancroft & Marsack, 1977 ;Sakinofsky, 2000) and has a strong association with eventual suicide (Ovenstone & Kreitman, 1974 ;Hawton & Fagg, 1988 ;Foster et al 1997 ;Sakinofsky, 2000). In a recent systematic review of problem-solving interventions for DSH patients, repetition was used as the outcome in a meta-analysis of the results of these treatments (Hawton et al 1998(Hawton et al , 2000.…”

Psychosocial interventions following self-harm in adults: a systematic review and meta-analysis

“…8 A history of self-harm is the strongest risk factor for suicide across a range of psychiatric disorders. 9 Repetition of self-harm further increases the risk of suicide. 10 Given the size of the problem of self-harm, the frequency with which it is repeated, and the risk of subsequent suicide, it is important that effective treatment interventions are developed for this patient population.…”

Prediction of repeated parasuicide after 1–12 months

“…Most studies use data collected at the index attempt. The following predictors for repetition within one year after index attempt have been identified; age 24 -54, single/divorced/ living alone, unemployed, lower social class, social isolation, female gender, criminal record, experience of physical violence, previous suicide attempt, cutting as method for index attempt, suicidal ideation, suicidal behaviour among relatives, depression and hopelessness, personality disorder, alcohol/ substance abuse, previous psychiatric treatment, referral to psychiatric treatment, use of psychotropic drugs, organic brain disorder, chronic somatic complaints [10,11,12,13,20,21,22]. Similar predictors have been found for repetition within 6 months [11,16,23].…”