Deliberate self-harm in children and adolescents: an 11-year case note study

AbstractObjective: To retrospectively examine the case-notes of all children and adolescents admitted with deliberate self-harm (DSH) or suicidal ideation during the study period 1993-2003. The study aimed to identify underlying reasons why children and adolescents engage in DSH, and to identify common psychiatric, psychosocial and familial factors which may predispose or contribute to an individual's engagement in such behaviour.Method: All children presenting to the hospital with DSH or suicidal ideation were identified and data collected from their case notes. A study specific questionnaire was designed to collect demographic details, details on clinical presentation, past attempts, comorbid psychiatry disorders, family history and family circumstances. Information was also recorded on hospital stay and discharge planning.Results: During the 11-year period, 231 children presented with suicidal ideation or behaviour. The mean age was 12.85 with an age range from 6-17 years, with a female:male ratio of 2.5:1. Overdose was the most common method (81.2%) and paracetamol most commonly the drug of choice. More than half of the group (55.7%) expressed a wish to die. More than half (51.8%) had expressed suicidal ideation in the past, 31% had made a previous attempt, and 11.7% had been previously admitted. Of the children 8% presented with suicidal behaviour more than once over the study period. There was a family history of completed suicide in 6.6%.Conclusion: Deliberate self-harm in young people is a significant public health problem in Ireland. During the period of this study, rates have continued to increase. There is an urgent need for national bodies such as the National Suicide Review Group to extend their focus to include those under age 18 and for services to be developed that might reduce DSH behaviours. More research is needed in the area of childhood suicidal behaviour.

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Household Survey of Pesticide Practice, Deliberate Self-Harm, and Suicide in the Sundarban Region of West Bengal, India

BioMed Research International ◽

10.1155/2013/949076 ◽

2013 ◽

Vol 2013 ◽

pp. 1-9 ◽

Cited By ~ 3

Author(s):

Sohini Banerjee ◽

Arabinda Narayan Chowdhury ◽

Esther Schelling ◽

Mitchell G. Weiss

Keyword(s):

Public Health ◽

Suicidal Behaviour ◽

Local Governments ◽

Public Health Problem ◽

Kappa Statistic ◽

Cross Sectional ◽

Deliberate Self Harm ◽

Safe Storage ◽

Intentional Ingestion ◽

Self Harm

The toxicological impact and intentional ingestion of pesticides are major public health concerns globally. This study aimed to estimate the extent of deliberate self-harm (DSH) and suicides (suicidal behaviour) and document pesticide practices in Namkhana block of the Sundarban region, India. A cross-sectional study was conducted in 1680 households (21 villages) following a mixed random and cluster design sampling. The survey questionnaire (Household Information on Pesticide Use and DSH) was developed by the research team to elicit qualitative and quantitative information. The Kappa statistic and McNemar’s test were used to assess the level of agreement and association between respondents’ and investigators’ opinions about safe storage of pesticides. Over five years, 1680 households reported 181 incidents of suicidal behaviour. Conflict with family members was the most frequently reported reason for suicidal behaviour (53.6%). The Kappa statistic indicated poor agreement between respondents and investigators about safe storage of pesticides. The pesticide-related annual DSH rate was 158.1 (95% CI 126.2–195.5), and for suicide it was 73.4 (95% CI 52.2–100.3) per 100,000. Unsafe pesticide practice and psychosocial stressors are related to the high rates of suicidal behaviour. An intersectoral approach involving the local governments, agricultural department and the health sector would help to reduce the magnitude of this public health problem.

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Global Lifetime and 12-Month Prevalence of Suicidal Behavior, Deliberate Self-Harm and Non-Suicidal Self-Injury in Children and Adolescents between 1989 and 2018: A Meta-Analysis

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph16224581 ◽

2019 ◽

Vol 16 (22) ◽

pp. 4581 ◽

Cited By ~ 20

Author(s):

Kim-San Lim ◽

Celine H. Wong ◽

Roger S. McIntyre ◽

Jiayun Wang ◽

Zhisong Zhang ◽

...

Keyword(s):

Suicidal Ideation ◽

Children And Adolescents ◽

Suicidal Behavior ◽

School Attendance ◽

Meta Analysis ◽

Full Time ◽

Deliberate Self Harm ◽

Self Injury ◽

Subgroup Analyses ◽

Self Harm

Objective: This meta-analysis aimed to estimate the global lifetime and 12-month prevalence of suicidal behavior, deliberate self-harm and non-suicidal self-injury in children and adolescents. Methods: A systematic search for relevant articles published between 1989 to 2018 was performed in multiple electronic databases. The aggregate 12-month and lifetime prevalence of suicidal behavior, deliberate self-harm, and non-suicidal self-injury were calculated based on the random-effects model. Subgroup analyses were performed to compare the prevalence according to school attendance and geographical regions. Results: A total of 686,672 children and adolescents were included. The aggregate lifetime and 12-month prevalence of suicide attempts was 6% (95% CI: 4.7–7.7%) and 4.5% (95% CI: 3.4–5.9%) respectively. The aggregate lifetime and 12-month prevalence of suicidal plan was 9.9% (95% CI: 5.5–17%) and 7.5% (95% CI: 4.5–12.1%) respectively. The aggregate lifetime and 12-month prevalence of suicidal ideation was 18% (95% CI: 14.2–22.7%) and 14.2% (95% CI: 11.6–17.3%) respectively. The aggregate lifetime and 12-month prevalence of non-suicidal self-injury was 22.1% (95% CI: 16.9–28.4%) and 19.5% (95% CI: 13.3–27.6%) respectively. The aggregate lifetime and 12-month prevalence of deliberate self-harm was 13.7% (95% CI: 11.0–17.0%) and 14.2% (95% CI: 10.1–19.5%) respectively. Subgroup analyses showed that full-time school attendance, non-Western countries, low and middle-income countries, and geographical locations might contribute to the higher aggregate prevalence of suicidal behaviors, deliberate self-harm, and non-suicidal self-injury. Conclusions: This meta-analysis found that non-suicidal self-injury, suicidal ideation, and deliberate self-harm were the three most common suicidal and self-harm behaviors in children and adolescents.

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Adolescents with suicidal behaviour: attendance at A&E and six month follow-up

Irish Journal of Psychological Medicine ◽

10.1017/s0790966700008405 ◽

2004 ◽

Vol 21 (3) ◽

pp. 78-84 ◽

Cited By ~ 8

Author(s):

Sharon Bolger ◽

Peter O'Connor ◽

Kevin Malone ◽

Carol Fitzpatrick

Keyword(s):

Mental Health ◽

Suicidal Ideation ◽

Young People ◽

Psychological Functioning ◽

Suicidal Behaviour ◽

Deliberate Self Harm ◽

History Of ◽

Self Harm ◽

Suicidal Crisis

AbstractObjectives: To review the clinical presentation, and Accident and Emergency Department clinical response to 14-20 year olds in suicidal crisis in inner city Dublin and to carry out a six month follow up of these young people.Method: A retrospective review of the case notes of all 14-20 year olds who had attended the Mater Hospital A&E department between June 2001 and May 2002 with suicidal behaviour or ideation was carried out in order to establish socio-demographic information, type of suicidal or self-harming behaviour, intervention in the A&E department, and discharge plan. Active outreach attempts were made to trace, contact and interview these young peoples at least six months after the initial presentation. Quantitative measures of psychological functioning at follow-up included the General Health Questionnaire, The Beck Depression Inventory and The Scale for Suicidal Ideation. A qualitative interview covered their recall of the reasons for their deliberate self harm, their view of their current psychological functioning and personal relationships, reported repetition of deliberate self harm, and their views of what type of services would be useful for young people with suicidal ideation or behaviour.Results: A total of 89 young people aged 14-20 years (male: female ratio = 2:3) presented to the Mater A&E department between June 2001 and May 2002 with deliberate self-harm, deliberate self-poisoning and/or suicidal ideation, and accounted for 108 presentations. They showed high levels of psychosocial disadvantage. Almost half had a history of previous contact with mental health services, while the same proportion had a history of previous deliberate self-harm. Drug overdose using paracetamol was the most common method used. Psychiatric assessment was documented in 66% of cases, and documented follow up recommendations were made in 60% of cases. Two thirds of the 89 young people who formed the study population were traced. Half of those contacted agreed to be interviewed and half refused. The majority of those interviewed described themselves as functioning better psychologically than at the time of the index attendance at the A&E department The quantitative measures supported this. One third of those interviewed reported repeated deliberate self-harm since their index attendance, for which most did not seek medical intervention. Many of the young people had clear views about the importance of talking to someone when in crisis. They described a service, which was informal, accessible on a 24-hour basis, and staffed by people with experience of mental health, alcohol and drug related disorders.Conclusions: This is a particularly vulnerable group of patients from a socio-demographic and mental health perspective. Their attendance at the A&E department provides a unique opportunity for an in-depth psychosocial assessment, which should be recorded in a systematic way to assist clinical audit, facilitate strategic mental health planning and may confer some therapeutic clinical benefit to at risk young people. An easily accessible, active DSH team specifically tailored for young people in the A&E department could provide assessment and short-term follow-up. This is the approach recommended by young people in suicidal crisis, whose views need to be heard.

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Family history of suicidal behaviour: prevalence and significance in deliberate self-harm patients

Acta Psychiatrica Scandinavica ◽

10.1034/j.1600-0447.2002.02003.x ◽

2002 ◽

Vol 106 (5) ◽

pp. 387-393 ◽

Cited By ~ 20

Author(s):

Keith Hawton ◽

Camilla Haw ◽

Kelly Houston ◽

Ellen Townsend

Keyword(s):

Family History ◽

Suicidal Behaviour ◽

Deliberate Self Harm ◽

History Of ◽

Self Harm

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Risk of deliberate self-harm and factors associated with suicidal behaviour among asymptomatic individuals with human immunodeficiency virus infection

Acta Psychiatrica Scandinavica ◽

10.1111/j.1600-0447.1992.tb03229.x ◽

1992 ◽

Vol 86 (1) ◽

pp. 70-75 ◽

Cited By ~ 30

Author(s):

C. Gala ◽

A. Pergami ◽

J. Catalan ◽

M. Riccio ◽

F. Durbano ◽

...

Keyword(s):

Human Immunodeficiency Virus ◽

Virus Infection ◽

Human Immunodeficiency Virus Infection ◽

Suicidal Behaviour ◽

Deliberate Self Harm ◽

Factors Associated ◽

Immunodeficiency Virus ◽

Self Harm ◽

Asymptomatic Individuals

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Suicidal behaviour and deliberate self-harm

Mental Health Handbook for Schools ◽

10.4324/9780203994863-15 ◽

2015 ◽

pp. 123-135

Keyword(s):

Suicidal Behaviour ◽

Deliberate Self Harm ◽

Self Harm

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2.52 SUICIDAL IDEATION/SELF-HARM IN CHILDREN AND ADOLESCENTS WITH TIC DISORDERS

Journal of the American Academy of Child & Adolescent Psychiatry ◽

10.1016/j.jaac.2019.08.144 ◽

2019 ◽

Vol 58 (10) ◽

pp. S187-S188

Author(s):

Maria Cruz ◽

Cynthia Fundora ◽

Irene Malaty ◽

Diana Shineman ◽

Barbara J. Coffey

Keyword(s):

Suicidal Ideation ◽

Children And Adolescents ◽

Tic Disorders ◽

Self Harm

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Factors associated with deliberate self-harm among Irish adolescents

Psychological Medicine ◽

10.1017/s0033291709992145 ◽

2010 ◽

Vol 40 (11) ◽

pp. 1811-1819 ◽

Cited By ~ 37

Author(s):

E. M. McMahon ◽

U. Reulbach ◽

P. Corcoran ◽

H. S. Keeley ◽

I. J. Perry ◽

...

Keyword(s):

Life Style ◽

Public Health Problem ◽

Cross Sectional Study ◽

Major Public Health Problem ◽

Cross Sectional ◽

Life Event ◽

Deliberate Self Harm ◽

Factors Associated ◽

Related Risk ◽

Self Harm

BackgroundDeliberate self-harm (DSH) is a major public health problem, with young people most at risk. Lifetime prevalence of DSH in Irish adolescents is between 8% and 12%, and it is three times more prevalent among girls than boys. The aim of the study was to identify the psychological, life-style and life event factors associated with self-harm in Irish adolescents.MethodA cross-sectional study was conducted, with 3881 adolescents in 39 schools completing an anonymous questionnaire as part of the Child and Adolescent Self-harm in Europe (CASE) study. There was an equal gender balance and 53.1% of students were 16 years old. Information was obtained on history of self-harm life events, and demographic, psychological and life-style factors.ResultsBased on multivariate analyses, important factors associated with DSH among both genders were drug use and knowing a friend who had engaged in self-harm. Among girls, poor self-esteem, forced sexual activity, self-harm of a family member, fights with parents and problems with friendships also remained in the final model. For boys, experiencing bullying, problems with schoolwork, impulsivity and anxiety remained.ConclusionsDistinct profiles of boys and girls who engage in self-harm were identified. Associations between DSH and some life-style and life event factors suggest that mental health factors are not the sole indicators of risk of self-harm. The importance of school-related risk factors underlines the need to develop gender-specific initiatives in schools to reduce the prevalence of self-harm.

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