Tags

Type your tag names separated by a space and hit enter

"Near-fatal" deliberate self-harm: characteristics, prevention and implications for the prevention of suicide.
J Affect Disord 2004; 79(1-3):263-8JA

Abstract

BACKGROUND

There have been few studies of the most serious cases of deliberate self-harm (DSH). These cases represent an important clinical problem. They may also be suitable as a "proxy" for suicide in research studies.

METHODS

We developed a definition of "near-fatal" deliberate self-harm (NFDSH) and identified all cases attending accident and emergency departments in an urban area during an 18-month period. We compared them to less severe DSH on social and clinical characteristics, and examined their initial clinical management. We compared their age and gender profile with that of completed suicides. NFDSH cases who agreed to be interviewed were asked about their experiences of seeking help and their views on prevention of suicide.

RESULTS

158 cases were identified, 8% of all DSH. The most common method of self-harm was self-poisoning. The most common psychiatric diagnosis was depression. Compared to less severe DSH, near-fatal cases had higher rates of several social and clinical risk factors for suicide and showed evidence of greater suicidal intent. Forty-one percent were allowed home following assessment. Most admissions lasted 2 days or less. The age and gender profile was closer to that of suicide than in DSH generally. Few subjects agreed to be interviewed; those who did described poor previous experiences of services.

LIMITATIONS

We did not assess each case of DSH individually but applied a workable definition of NFDSH. Firm conclusions cannot be drawn from the qualitative part of the study because of the low rate of agreement to interview.

CONCLUSIONS

NFDSH is an important clinical phenomenon associated with indicators of high suicide risk. This high risk is frequently not reflected in clinical management. Further studies of NFDSH could contribute to what is known about suicide prevention but the reluctance of NFDSH subjects to be interviewed may be a difficulty for future research.

Authors+Show Affiliations

Centre for Suicide Prevention, University of Manchester, Manchester M13 9PL, UK.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Multicenter Study

Language

eng

PubMed ID

15023505

Citation

Douglas, Julie, et al. ""Near-fatal" Deliberate Self-harm: Characteristics, Prevention and Implications for the Prevention of Suicide." Journal of Affective Disorders, vol. 79, no. 1-3, 2004, pp. 263-8.
Douglas J, Cooper J, Amos T, et al. "Near-fatal" deliberate self-harm: characteristics, prevention and implications for the prevention of suicide. J Affect Disord. 2004;79(1-3):263-8.
Douglas, J., Cooper, J., Amos, T., Webb, R., Guthrie, E., & Appleby, L. (2004). "Near-fatal" deliberate self-harm: characteristics, prevention and implications for the prevention of suicide. Journal of Affective Disorders, 79(1-3), pp. 263-8.
Douglas J, et al. "Near-fatal" Deliberate Self-harm: Characteristics, Prevention and Implications for the Prevention of Suicide. J Affect Disord. 2004;79(1-3):263-8. PubMed PMID: 15023505.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - "Near-fatal" deliberate self-harm: characteristics, prevention and implications for the prevention of suicide. AU - Douglas,Julie, AU - Cooper,Jayne, AU - Amos,Tim, AU - Webb,Roger, AU - Guthrie,Elspeth, AU - Appleby,Louis, PY - 2002/06/19/received PY - 2002/09/27/revised PY - 2002/10/25/accepted PY - 2004/3/17/pubmed PY - 2004/6/23/medline PY - 2004/3/17/entrez SP - 263 EP - 8 JF - Journal of affective disorders JO - J Affect Disord VL - 79 IS - 1-3 N2 - BACKGROUND: There have been few studies of the most serious cases of deliberate self-harm (DSH). These cases represent an important clinical problem. They may also be suitable as a "proxy" for suicide in research studies. METHODS: We developed a definition of "near-fatal" deliberate self-harm (NFDSH) and identified all cases attending accident and emergency departments in an urban area during an 18-month period. We compared them to less severe DSH on social and clinical characteristics, and examined their initial clinical management. We compared their age and gender profile with that of completed suicides. NFDSH cases who agreed to be interviewed were asked about their experiences of seeking help and their views on prevention of suicide. RESULTS: 158 cases were identified, 8% of all DSH. The most common method of self-harm was self-poisoning. The most common psychiatric diagnosis was depression. Compared to less severe DSH, near-fatal cases had higher rates of several social and clinical risk factors for suicide and showed evidence of greater suicidal intent. Forty-one percent were allowed home following assessment. Most admissions lasted 2 days or less. The age and gender profile was closer to that of suicide than in DSH generally. Few subjects agreed to be interviewed; those who did described poor previous experiences of services. LIMITATIONS: We did not assess each case of DSH individually but applied a workable definition of NFDSH. Firm conclusions cannot be drawn from the qualitative part of the study because of the low rate of agreement to interview. CONCLUSIONS: NFDSH is an important clinical phenomenon associated with indicators of high suicide risk. This high risk is frequently not reflected in clinical management. Further studies of NFDSH could contribute to what is known about suicide prevention but the reluctance of NFDSH subjects to be interviewed may be a difficulty for future research. SN - 0165-0327 UR - https://www.unboundmedicine.com/medline/citation/15023505/"Near_fatal"_deliberate_self_harm:_characteristics_prevention_and_implications_for_the_prevention_of_suicide_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0165032702003919 DB - PRIME DP - Unbound Medicine ER -