Suicide in the 18 Years After Deliberate Self-harm

1996 ◽  
Vol 169 (4) ◽  
pp. 489-494 ◽  
Author(s):  
Gregory M. De Moore ◽  
Andrew R. Robertson
Keyword(s):  
Strong Predictor ◽  
Young Male ◽  
Demographic Information ◽  
Specific Data ◽  
Deliberate Self Harm ◽  
Male Suicide ◽  
Completed Suicide ◽  
Self Harm ◽  
Sydney Australia

BackgroundClinical and demographic information on patients seen as a result of deliberate self-harm (DSH) was collected in an attempt to identify factors in the index episode of DSH predictive of subsequent suicide.MethodSpecific data were prospectively collected on all DSH patients who lived in Blacktown Municipality, Sydney, Australia, and seen from October 1975 to September 1976. Follow-up at 18 years was by evaluation of coroners' records and identification of ‘probable suicide’.ResultsTwo hundred and twenty-three patients harmed themselves on one or more occasions. Follow-up at 18 years showed that 15 of the 223 (6.7%) had completed suicide. The proportion at five and eight years was 4.0% and at 10 years was 4.5%. Identified predictors of suicide were: narcotic overdose; more than one episode of DSH in the year of the study; planned episode; and mental illness. Teenage narcotic-abusing males were at greatest risk, and in females a planned episode was the most powerful predictor.ConclusionsSuicides continued to occur over 18 years. One of the striking differences between this and other studies is the finding of teenage male DSH, associated with narcotic abuse, as a strong predictor of subsequent suicide. These findings are particularly relevant to the issue of young male suicide, which increased from the 1970s onwards in Australia and elsewhere.

scholarly journals Repetition of deliberate self-harm and subsequent suicide risk: Long-term follow-up study of 11 583 patients

2004 ◽  
Vol 185 (1) ◽  
pp. 70-75 ◽  
Author(s):  
Daniel Louis Zahl ◽  
Keith Hawton
Keyword(s):  
Relative Risk ◽  
Suicide Risk ◽  
Single Episode ◽  
Deliberate Self Harm ◽  
Young Females ◽  
Follow Up Study ◽  
Increased Risk ◽  
Self Harm

BackgroundRepetition of deliberate self-harm (DSH) is a risk factor for suicide. Little information is available on the risk for specific groups of people who deliberately harm themselves repeatedly.AimsTo investigate the long-term risk of suicide associated with repetition of DSH by gender, age and frequency of repetition.MethodA mortality follow-up study to the year 2000 was conducted on 11583 people who presented to the general hospital in Oxford between 1978 and 1997. Repetition of DSH was determined from reported episodes prior to the index episode and episodes presenting to the same hospital during the follow-up period. Deaths were identified through national registers.ResultsThirty-nine percent of patients repeated the DSH. They were at greater relative risk of suicide than the single-episode DSH group (2.24; 95% CI 1.77–2.84). The relative risk of suicide in the repeated DSH group compared with the single-episode DSH group was greater in females (3.5; 95% C11.3–2.4) than males (1.8; 95% C1 2.3–5.3) and was inversely related to age (up to 54 years). Suicide risk increased further with multiple repeat episodes of DSH in females.ConclusionsRepetition of DSH is associated with an increased risk of suicide in males and females. Repetition may be a better indicator of risk in females, especially young females.

Suicide and deliberate self-harm in elderly people

2012 ◽  
pp. 1564-1567
Author(s):  
Robin Jacoby
Keyword(s):  
Older People ◽  
Old Age ◽  
Terminal Illness ◽  
Assisted Suicide ◽  
Total Population ◽  
Developed Countries ◽  
Deliberate Self Harm ◽  
Young Males ◽  
Completed Suicide ◽  
Self Harm

Although in some countries suicide rates in young males have risen dramatically in the last decade or so, suicide in old age is important because rates in older people, especially those over 74, are still proportionately higher in most countries of the world where reasonably reliable statistics can be obtained. For example, in 2004 in Lithuania where suicide incidence is currently the highest, the overall rate in males per 100 000 total population was 70.1, but in men over 74 the rate was 80.2. In the United States, where suicide is neither especially common nor rare, in 2002 the overall rate for males per 100 000 total population was 17.9, but 40.7 in men over 74. Rates for older women are nearly always much lower than for their male counterparts. A second reason for the importance of suicide in old age is that the proportion of older people in the population is rising worldwide. Indeed, the increase in developing countries is likely to be even greater than in developed countries. Although rates vary from year to year and birth cohort to cohort, it is highly likely that unless suicide prevention becomes a great deal more effective than at present, more and more older people will kill themselves in the coming years. As with younger people, completed suicide in old age may be seen as part of a continuum from suicidal thinking through deliberate self-harm (which does not lead to death), to completed suicide. An added component within this continuum for older people is that of ‘indirect self-destructive behaviour’, such as refusal to eat and drink or ‘turning one's face to the wall’ which is clearly intended to hasten death. Finally, although this section does not deal with euthanasia and related issues, assisted suicide in people with terminal illness such Alzheimer's disease and cancer may also be seen as part of the suicide continuum.

scholarly journals Background stressors and deliberate self-harm

2003 ◽  
Vol 27 (11) ◽  
pp. 411-415 ◽  
Author(s):  
Helen S. Keeley ◽  
Mary O'Sullivan ◽  
Paul Corcoran
Keyword(s):  
Life Events ◽  
Interpersonal Problems ◽  
Dysfunctional Family ◽  
Deliberate Self Harm ◽  
Monitoring Study ◽  
History Of ◽  
Self Harm ◽  
Background History ◽  
Prospective Monitoring

Aims and MethodIn this study we aimed to identify negative life events, especially those associated with repetition, in the background histories of patients in a 2-year prospective monitoring study of hospital-treated deliberate self-harm (DSH). Thematic analysis of the narratives recorded during assessment was used to produce general categories of life events.ResultsIn 3031 DSH episodes (n=2287 individuals), women reported more life events than men. Family and interpersonal problems were most commonly reported. Reporting a dysfunctional family of origin, a history of sexual abuse and the imprisonment of self or other were associated with repetition retrospectively and prospectively.Clinical ImplicationsThe background history of patients who harm themselves should be explored routinely on assessment in order to help establish risk of repetition and to determine appropriate follow-up.

scholarly journals Managing organisational change to improve health services for young people with deliberate self harm behaviour

2001 ◽  
Vol 24 (2) ◽  
pp. 143 ◽  
Author(s):  
Margaret J Tobin ◽  
Adam R Clarke ◽  
Richard Buss ◽  
Stewart L Einfeld ◽  
John Beard ◽  
...  
Keyword(s):  
Mental Health ◽  
Risk Factor ◽  
Young People ◽  
Organisational Change ◽  
Change Strategies ◽  
Deliberate Self Harm ◽  
Completed Suicide ◽  
Service Engagement ◽  
Self Harm ◽  
Improve Health

Repeat Deliberate Self Harm is a recognised risk factor for completed suicide and therefore reduction by effective healthservice response represents a valid contribution to suicide prevention. However, only a small fraction of people withdeliberate self harm presentations to general health settings actually reach specialist mental health follow-upappointments. Therefore, even if responses at that point are known to be effective they do not make a significantcontribution to reducing repeat self-harm overall. We describe health system organisational change strategies to improvehealth service engagement for the target group, and present data demonstrating the effectiveness of these strategies.

Early predictors of deliberate self-harm among adolescents. A prospective follow-up study from age 3 to age 15

2006 ◽  
Vol 93 (1-3) ◽  
pp. 87-96 ◽  
Author(s):  
Andre Sourander ◽  
Minna Aromaa ◽  
Leena Pihlakoski ◽  
Antti Haavisto ◽  
Päivi Rautava ◽  
...  
Keyword(s):  
Deliberate Self Harm ◽  
Follow Up Study ◽  
Early Predictors ◽  
Self Harm

Hostility, hopelessness and deliberate self-harm: a prospective follow-up study

1990 ◽  
Vol 81 (3) ◽  
pp. 280-283 ◽  
Author(s):  
A. D. Brittlebank ◽  
A. Cole ◽  
F. Hassanyeh ◽  
M. Kenny ◽  
D. Simpson ◽  
...  
Keyword(s):  
Deliberate Self Harm ◽  
Follow Up Study ◽  
Self Harm

Secondary Prevention of Non-fatal Deliberate Self-harm

1993 ◽  
Vol 163 (1) ◽  
pp. 111-112 ◽  
Author(s):  
H. G. Morgan ◽  
E. M. Jones ◽  
J. H. Owen
Keyword(s):  
British Journal ◽  
Early Stage ◽  
Psychiatric Services ◽  
Easy Access ◽  
Deliberate Self Harm ◽  
Self Harm ◽  
One Year ◽  
First Time ◽  
Experimental Group

In an attempt to address the low compliance with offers of treatment shown by patients after episodes of non-fatal deliberate self-harm (DSH), patients who had harmed themselves for the first time were offered rapid, easy access to on-call trainee psychiatrists in the event of further difficulties, and they were encouraged to seek help at an early stage should such problems arise. The follow-up data obtained after one year showed a significant reduction of actual or seriously threatened DSH in the experimental group, who also made considerably less demands on medical and psychiatric services, when compared with controls.British Journal of Psychiatry (1993), 163, 111–112

THE TREATMENT OF DELIBERATE SELF-HARM IN BORDERLINE PERSONALITY DISORDER USING DIALECTICAL BEHAVIOUR THERAPY: A PILOT STUDY IN A HIGH SECURITY HOSPITAL

2001 ◽  
Vol 29 (1) ◽  
pp. 85-92 ◽  
Author(s):  
Gail Low ◽  
David Jones ◽  
Conor Duggan ◽  
Mick Power ◽  
Andrew MacLeod
Keyword(s):  
Borderline Personality Disorder ◽  
Personality Disorder ◽  
Suicide Ideation ◽  
Borderline Personality ◽  
Institutional Setting ◽  
Behaviour Therapy ◽  
Deliberate Self Harm ◽  
Dialectical Behaviour Therapy ◽  
Self Harm

Deliberate self-harm (DSH) presents a significant health problem, especially as treatments have not been particularly successful in reducing repetition. Dialectical behaviour therapy (DBT; Linehan, 1993) is one approach that has reported some success in reducing self-harm rates in borderline personality disorder patients, who self-harm frequently, though it remains largely untested outside its original setting. The present study aimed to assess the effectiveness of DBT in self-harming women in an institutional setting in the United Kingdom where self-harm is common. Female patients at Rampton Hospital who were displaying self-harming behaviour and met criteria for borderline personality disorder (N = 10) participated in the full one-year treatment package of DBT. Patients were assessed on self-harm rates and on a number of psychological variables, pre-, during- and post-therapy, including a 6-month follow-up. There was a significant reduction in DSH during therapy, which was maintained at 6-month follow-up. This was paralleled by a reduction in dissociative experiences and an increase in survival and coping beliefs, alongside improvements in depression, suicide ideation, and impulsiveness. The findings are preliminary but the results suggest that DBT might provide an effective treatment for severe self-harm in institutional settings, and also highlight some of the psychological mechanisms that might mediate these improvements in self-harming behaviour.

The Development of Behavioural Coping Skills in a Repetitive and Deliberately Self-Harming Young Woman

2004 ◽  
Vol 33 (2) ◽  
pp. 237-242 ◽  
Author(s):  
Malcolm Wheatley ◽  
Clive Hollin
Keyword(s):  
Young Woman ◽  
Coping Skills ◽  
Single Case ◽  
Ethical Considerations ◽  
Deliberate Self Harm ◽  
Intervention Phase ◽  
Assessment Period ◽  
Effective Delivery ◽  
Self Harm

This project reports on the effective delivery of a behavioural coping skills programme with a repetitive deliberately self-harming young woman. A simple single case A-B design was employed to evaluate the intervention due to the applied nature of the project and ethical considerations. An assessment period prior to the intervention phase constituted an extended baseline. Data concerning the primary dependent variable, deliberate self-harm, were collected for a 3-month follow-up period.

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