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Suicide after deliberate self-harm: a 4-year cohort study.
Jayne Cooper1, Navneet Kapur, Roger Webb
1Centre for Suicide Prevention, University of Manchester, 7th Floor, Williamson Building, Oxford Road, Manchester M13 9PL, UK. jayne.cooper@man.ac.uk
The American Journal of Psychiatry
|January 29, 2005
Summary
Individuals who self-harm face a significantly higher suicide risk, especially women. Early intervention focusing on physical health, substance misuse, and social support is crucial for suicide prevention.
Area of Science:
- Public Health
- Epidemiology
- Psychiatry
Background:
- Deliberate self-harm is a significant public health concern.
- Understanding long-term suicide risk after self-harm is vital for prevention.
Purpose of the Study:
- To estimate suicide rates following deliberate self-harm.
- To investigate temporal trends in suicide risk.
- To identify predictors of suicide in this population.
Main Methods:
- Prospective cohort study of 7,968 individuals attending emergency departments for self-harm.
- Calculation of suicide rates and standardized mortality ratios (SMRs).
- Cox proportional hazards models used to analyze risk factors.
Main Results:
- A 30-fold increased suicide risk observed in the cohort compared to the general population.
- Suicide rates were highest within six months post-self-harm.
- Predictors included avoiding discovery, living alone, prior psychiatric treatment, self-mutilation, alcohol misuse, and physical health issues. Female patients had a higher SMR.
Conclusions:
- Early intervention post-self-harm is critical for suicide prevention.
- Treatment strategies should address physical illness, alcohol problems, and social circumstances.
- Female patients exhibiting self-harm represent a particularly high-risk group for suicide.