Risk factors for repetition and suicide following self-harm in older adults: multicentre cohort study

Abstract

Older adults presenting to hospital with self-harm are a high-risk group for subsequent suicide, particularly older men.

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

“…6 Self-harm is also often repeated, with 15-25% of individuals who present to hospital with self-harm re-presenting following a repeat episode within a year, 7 although the risk of repetition is lower in adults of older age. 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.…”

Attempted Suicide in Older People: A Review of the Evidence

“…Typically, the suicide rate for women shows a gradual increase with age, while men's suicide rate first peaks in middle adulthood, showing a marginal decline until a dramatic increase for the 75 and over group (World Health Organization, 2002). The present study revealed a higher proportion of elderly female attempters (Sharlin et al, 1997;Gavrielatos et al, 2006;Hawton et al, 2006) (1.6:1, 2.7:1, 1.7:1) versus a higher male to female ratio reported by Murphy et al (2012) 1.2:1, with Kim et al (2011) reporting a 1:1 ratio. Explanations for gender differences within the study populations were culturally situated.…”

“…Whilst living with family is normally thought of as protective against mental illness, 60% of patients who presented in Packer et al (2012) UK study were living with family. Murphy et al (2012) identified independent risk factors for non-fatal repetition of self-harm in people aged 60-74 years, with previous episode of self-harm and previous psychiatric treatment. According to Hawton et al (2006), relatively few patients were in psychiatric care at the time of their attempt, although four out of ten had a history of previous psychiatric treatment.…”

“…The risk of subsequent suicidal behavior is substantial in elderly suicide (Kim, 2014). A study by Murphy et al (2012) found that the risk of suicide was 67 times higher among older adults presenting to hospital with self-harm relative to the general population. Research into suicides and attempted suicides of older people is often concerned with understanding the nature and prevalence of risk factors contributing to harm.…”

Is there a difference between hospital-verified and self-reported self-harm? Implications for repetition

“…8 Furthermore, approximately 40-60% of people who die by suicide 59 will have presented with at least one episode of SH making it a strong predictor of suicidal 60 intentions . 9 …”