Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Citation Map Email this article to a Colleague Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to My Articles & Searches Download to citation manager Citing Articles via HighWire Citing Articles via Google Scholar Articles by Cooper, J. Articles by Appleby, L. Search for Related Content PubMed Citation Articles by Cooper, J. Articles by Appleby, L. Symptoms/Dimensions Suicide Related Article

Suicide After Deliberate Self-Harm: A 4-Year Cohort Study

OBJECTIVE: The purposes of this study were to estimate suicide rates up to 4 years after a deliberate self-harm episode, to investigate time-period effects on the suicide rate over the follow-up period, and to examine potential sociodemographic and clinical predictors of suicide within this cohort. METHOD: This prospective cohort study included 7,968 deliberate self-harm attendees at the emergency departments of four hospital trusts in the neighboring cities of Manchester and Salford, in northwest England, between September 1, 1997, and August 31, 2001. Suicide rates and standardized mortality ratios (SMRs) for the cohort were calculated. Potential risk factors were investigated by using Cox’s proportional hazards models. RESULTS: Sixty suicides occurred in the cohort during the follow-up period. An approximately 30-fold increase in risk of suicide, compared with the general population, was observed for the whole cohort. The SMR was substantially higher for female patients than for male patients. Suicide rates were highest within the first 6 months after the index self-harm episode. The independent predictors of subsequent suicide were avoiding discovery at the time of self-harm, not living with a close relative, previous psychiatric treatment, self-mutilation, alcohol misuse, and physical health problems. CONCLUSIONS: The results highlight the importance in a suicide prevention strategy of early intervention after an episode of self-harm. Treatment should include attention to physical illness, alcohol problems, and living circumstances. Self-harm appears to confer a particularly high risk of suicide in female patients.

Related Article:

In This Issue
Am J Psychiatry 2005 162: A46. [Full Text] [PDF]

This article has been cited by other articles:

				N T Fear, V R Ward, K Harrison, L Davison, S Williamson, and N F Blatchley Suicide among male regular UK Armed Forces personnel, 1984-2007 Occup. Environ. Med., July 1, 2009; 66(7): 438 - 441. [Abstract] [Full Text] [PDF]

				A. Lee, S.Y.S. Wong, K.K. Tsang, G.S.M. Ho, C.W. Wong, and F. Cheng Understanding suicidality and correlates among Chinese secondary school students in Hong Kong Health Promot. Int., June 1, 2009; 24(2): 156 - 165. [Abstract] [Full Text] [PDF]

				F. Heyerdahl, M. A. Bjornaas, R. Dahl, K. E. Hovda, A. K. Nore, O. Ekeberg, and D. Jacobsen Repetition of acute poisoning in Oslo: 1-year prospective study The British Journal of Psychiatry, January 1, 2009; 194(1): 73 - 79. [Abstract] [Full Text] [PDF]

				R. Lilley, D. Owens, J. Horrocks, A. House, R. Noble, H. Bergen, K. Hawton, D. Casey, S. Simkin, E. Murphy, et al. Hospital care and repetition following self-harm: multicentre comparison of self-poisoning and self-injury The British Journal of Psychiatry, June 1, 2008; 192(6): 440 - 445. [Abstract] [Full Text] [PDF]

				X. Liu Adolescent suicidal ideation predicts suicidal behaviour and psychopathological problems at age 30 Evid. Based Ment. Health, May 1, 2007; 10(2): 62 - 62. [Full Text] [PDF]

				A. JOHNSTON, J. COOPER, R. WEBB, and N. KAPUR Individual- and area-level predictors of self-harm repetition The British Journal of Psychiatry, November 1, 2006; 189(5): 416 - 421. [Abstract] [Full Text] [PDF]

				M. Olfson, S. C. Marcus, and D. Shaffer Antidepressant drug therapy and suicide in severely depressed children and adults: a case-control study. Arch Gen Psychiatry, August 1, 2006; 63(8): 865 - 872. [Abstract] [Full Text] [PDF]

				A J Mitchell and M Dennis Self harm and attempted suicide in adults: 10 practical questions and answers for emergency department staff. Emerg. Med. J., April 1, 2006; 23(4): 251 - 255. [Abstract] [Full Text] [PDF]

				I. Sakinofsky Attendance at accident and emergency for deliberate self harm predicts increased risk of suicide, especially in women Evid. Based Ment. Health, November 1, 2005; 8(4): 97 - 97. [Full Text] [PDF]

				Minerva BMJ, May 14, 2005; 330(7500): E355 - E355. [Full Text] [PDF]

				Completed Suicide Following Attempts and Gestures Journal Watch Psychiatry, March 9, 2005; 2005(309): 3 - 3. [Full Text]

				Minerva BMJ, February 19, 2005; 330(7488): 428 - 428. [Full Text] [PDF]

Get information about faster international access.

Privacy Policy

Copyright © 2005 American Psychiatric Association. All rights reserved.

Home | Search | Current Issue | Past Issues | Subscribe | All APPI Journals | Help | Contact Us