[Epidemiology of attempted suicide in The Hague]

To estimate the incidence of parasuicide in a metropolitan area and to identify subgroups of individuals with the purpose of developing secondary preventive strategies.

Longitudinal prospective case register study (1987-1993).

In the city of the Hague, the Netherlands, all individual contacts concerning parasuicidal behaviour were registered by the participating facilities i.e., hospitals, community mental health organizations and emergency services. Demographic and case-related information was recorded. Record linkage of the anonymized data including those of the municipal coroner concerning suicide was done by the project administration for longitudinal monitoring.

Over the registration period of 7 years (1987-1993) 4458 parasuicidal acts were recorded involving 3333 individuals. The age and sex distribution was in accordance with formerly published national and local data, but the real numbers of parasuicide rates were 50-100% higher than those usually presented in the literature. Repetition of parasuicide during an average follow-up period of 3.8 years occurred in 18.2% of all cases and the repetition rate increased over time. The suicide risk within a year after the last registered parasuicide came to 1.5% for men as well as women, and that within four years to 1.9% for women and 2.9% for men. Men and women with a history of three or more acts of parasuicide had a suicide risk of over 5% in a follow-up period of 4 years. The incidence of parasuicide was highest in the younger age groups of non-European women (including Turkish women), in particular those with an ethnocultural background in Surinam.