Epidemiology of deliberate self-poisoning: trends in hospital attendances

A number of reports have suggested that the incidence of deliberate self-harm has been declining since the late 1970s. Most of these findings have emerged from studies of hospital inpatients, but a large proportion of patients are sent home directly from Accident and Emergency Departments. This study, based in the Nottingham Accident and Emergency Department, looked at attendances for deliberate self-poisoning over four separate years in the period between 1981 and 1988. The findings show a slight reduction over time in the number of attendances and overall rates, with age-specific rates holding steady for the younger age-group (15-34 years), but diminishing as age increases. It is argued that age-specific trends, based on inpatient statistics, could be distorted by Accident and Emergency discharges. It is recommended that future epidemiological studies of deliberate self-harm include patients who progress no further than the Accident and Emergency Department.