Switching suicide methods as a predictor of completed suicide in individuals with repeated self-harm: A community cohort study in northern Taiwan

Wang, Liang‐Jen; Huang, Yu‐Chi; Lee, Sheng-Yu; Wu, Ya-Wen; Chen, Chih‐Ken

doi:10.1177/0004867414553951

Cited by 21 publications

(27 citation statements)

References 34 publications

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“…Several studies have examined method-switching following self-harm [ 10 , 23 , 24 , 29 , 58 ] and a previous review found that no discernible patterns in terms of escalation to methods of potential lethality can be identified [ 23 ]. The most common pattern of method-switching reported in many studies is from self-injury, including using methods with high potential lethality (e.g., drowning, hanging and jumping) [ 25 , 26 ], to self-poisoning [ 23 ]. While the risk of method-switching and repetition is lower for IDO than other methods [ 24 ], most people who die by suicide have used the methods of IDO or cutting in their index episodes [ 29 ].…”

Section: Discussionmentioning

confidence: 99%

“…Within this study, 16% of young people who switched method after an index episode of IDO switched to attempted hanging in their next repetition episode and 9% to attempted drowning. These patterns—together with increasing trends in the use of methods with high potential lethality among young people [ 3 ]—are concerning as switching to a more lethal method in repeat self-harm is a significant predictor of suicide [ 26 ]. This and other research recommend that all young people who present to hospital following self-harm should receive a mental health assessment [ 23 , 59 ], in line with best practice guidelines [ 51 , 60 ].…”

Section: Discussionmentioning

confidence: 99%

“…A recent multicenter study among 10–18-year-olds identified that switching to methods with increased lethality was common, specifically from self-poisoning to hanging or asphyxiation [ 10 ]. There are indications that individuals who use methods with high potential lethality (e.g., attempted drowning, gassing, firearms, hanging and jumping) are more likely to switch methods, than those who use methods with lower potential lethality (e.g., IDO and self-cutting) [ 15 , 25 , 26 ]. Method-switching varies by age, with 37% of people under 25 years switching their non-fatal self-harm method within an average of 2.8 years [ 15 ].…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Repeat Self-Harm Following Hospital-Presenting Intentional Drug Overdose among Young People—A National Registry Study

Daly

Griffin

McMahon

et al. 2020

IJERPH

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Background: The incidence of hospital-presenting self-harm peaks among young people, who most often engage in intentional drug overdose (IDO). The risk of self-harm repetition is high among young people and switching methods between self-harm episodes is common. However, little is known about their patterns of repetition and switching following IDO. This study aimed to investigate repeat self-harm and method-switching following hospital-presenting IDO among young people. Methods: Data from the National Self-Harm Registry Ireland on hospital-presenting self-harm by individuals aged 10–24 years during 2009–2018 were examined. Cox proportional hazards regression models with associated hazard ratios (HRs), survival curves and Poisson regression models with risk ratios (RRs), were used to examine risk factors for repetition and method-switching. Results: During 2009–2018, 16,800 young people presented following IDO. Within 12 months, 2136 young people repeated self-harm. Factors associated with repetition included being male (HR = 1.13, 95% CI: 1.03–1.24), aged 10–17 years (HR = 1.29, 95% CI: 1.18–1.41), consuming ≥ 50 tablets (HR = 1.27, 95% CI: 1.07–1.49) and taking benzodiazepines (HR = 1.67, 95% CI: 1.40–1.98) or antidepressants (HR = 1.36, 95% CI: 1.18–1.56). The cumulative risk for switching method was 2.4% (95% CI: 2.2–2.7). Method-switching was most likely to occur for males (RR = 1.36; 95% CI: 1.09–1.69) and for those who took illegal drugs (RR = 1.63; 95% CI: 1.19–2.25). Conclusion: Young males are at increased risk of repeat self-harm and method-switching following IDO and the type and quantity of drugs taken are further indicators of risk. Interventions targeting IDO among young people are needed that ensure that mental health assessments are undertaken and which address access to drugs.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Repeat Self-Harm Following Hospital-Presenting Intentional Drug Overdose among Young People—A National Registry Study

Daly

Griffin

McMahon

et al. 2020

IJERPH

View full text Add to dashboard Cite

show abstract

“…Among the suicide behaviors, poisoning and cutting/piercing are regarded as low-lethal methods; but charcoal burning and poisoning by gases, hanging, and jumping from high places belong to the high-lethal methods [ 39 ]. Compared with those aged ≥65 years, patients aged between 20 and 49 years were observed to be less likely to choose a highly lethal method when attempting suicide [ 40 , 41 ].…”

Section: Discussionmentioning

confidence: 99%

A Retrospective Administrative Database Analysis of Suicide Attempts and Completed Suicide in Patients With Chronic Pancreatitis

et al. 2018

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Background: The actual incidence rate of suicide attempt and the suicide-related fatality rate (completed suicide) in patients with chronic pancreatitis (CP) have not been mentioned in the literature.Methods: We conducted a nationwide population-based cohort study by analyzing data from Taiwan's National Health Insurance Research Database (NHIRD) to compare the rate of suicide attempt between a CP cohort and a non-CP cohort. For the study cohort, we identified 17,733 patients (age ≥ 20 years) diagnosed as having CP between 2000 and 2010 from the NHIRD in Taiwan. Beneficiaries with no history of CP were matched with the study cohort at a 2:1 ratio according to age, sex, and index date. To determine the incidence of suicide, all patients were followed until the end of 2011 or until their withdrawal from the Taiwan National Health Insurance program.Results: Patients with CP had an increased risk of suicide attempt, compared with those without CP (adjusted hazard ratio [aHR] = 2.72, 95% confidence interval [CI] = 1.69–4.37). The suicide-related fatality in the CP cohort was higher than that in the non-CP cohort, but the difference was not statistically significant (aHR = 1.21, 95% CI = 0.39–3.78).Conclusion: Our population-based cohort study reveals a close association between CP and subsequent suicide attempt. Compared with the non-CP cohort, the suicide-related fatality was higher in the CP cohort, although the result was not statistically significant. These findings necessitate surveying patients with CP and providing psychological support to prevent suicide.

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“…Кумулятивный риск повторения аутоагрессии превышает 9% в течение первого года после индекс-эпизода и 14% в течение ближайших трех лет [10]. Переход к использованию высоколетальных способов в последующих суицидальных попытках считается очень серьезным предиктором завершенного суицида [11].…”

unclassified

Uncompleted suicide attempts in adolescents

Mazaeva

Кравченко

Зикеев

2016

Z. nevrol. psikhiatr. im. S.S. Korsakova

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Among all hospitalized on medical emergencies suicidal behavior was identified in 42%, repeated suicidal attempts were in 27% of boys and in 47% of girls. Mental disorders on admission and in the past history were found in 75%; 25% of the patients received psychiatric examination and treatment. Personality disorders and adaptation disorders were most prevalent; schizophrenia spectrum disorders made up 13%. Common features of suicidal behavior in adolescents were: the use of low fatal methods, mild expression of antivital feelings, short duration of pre-suicidal stage, suddenness of commitment of suicidal actions, an additional stressful event (conflict situation) for the development of suicidal behavior. Significant differences in the methods of realization of suicidal intentions, preferable character of suicidal behavior (blackmailing/demonstrative in girls, brutal and compulsive in boys) and typology of psychopathological symptoms were established.

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Switching suicide methods as a predictor of completed suicide in individuals with repeated self-harm: A community cohort study in northern Taiwan

Abstract: The findings in this study give us some insight into the patterns of methods in repeat suicide attempters. The intent behind switching methods of suicide attempt might be considered as an important item of clinical assessment of the seriousness of suicidal behavior.

Cited by 21 publications

References 34 publications

Repeat Self-Harm Following Hospital-Presenting Intentional Drug Overdose among Young People—A National Registry Study

Repeat Self-Harm Following Hospital-Presenting Intentional Drug Overdose among Young People—A National Registry Study

A Retrospective Administrative Database Analysis of Suicide Attempts and Completed Suicide in Patients With Chronic Pancreatitis

Uncompleted suicide attempts in adolescents

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