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Deliberate Self-Harm (DSH): a follow-up study of Irish children

C Cassidy1, F McNicholas, R Lennon

  • 1Department of Child Psychiatry, Our Lady's Children's Hospital, Crumlin, Dublin.

Irish Medical Journal
|June 26, 2009
PubMed

Insights

One in five female adolescents presenting with Deliberate Self-Harm (DSH) repeated attempts, while no males did. Ongoing parental concern, not clinician assessment, predicted repeat DSH in this pediatric emergency department study.

Area of Science:

  • Pediatric Emergency Medicine
  • Child and Adolescent Psychiatry
  • Public Health

Background:

  • Deliberate Self-Harm (DSH) is a significant concern in pediatric populations.
  • Understanding repetition rates is crucial for effective intervention and risk management.
  • Previous research has explored risk factors, but specific data on pediatric DSH repetition in emergency settings is limited.

Purpose of the Study:

  • To determine the rates of repeat Deliberate Self-Harm (DSH) among children and adolescents presenting to a pediatric Accident and Emergency (A&E) department.
  • To identify predictors of DSH repetition in this demographic.
  • To evaluate the role of parental concern versus clinician risk assessment in predicting repeat DSH.

Main Methods:

  • A retrospective study design was employed, inviting children and adolescents who presented with DSH between 2000 and 2005.
  • Data collection involved telephone interviews with parents and children, gathering demographic information and assessing mental health functioning.
  • Information on previous and subsequent DSH attempts was specifically collected.

Main Results:

  • Among the participants (39 parents, 10 children; 31 girls, 8 boys; mean age 15), 20% of females repeated DSH, and 10% repeated more than once.
  • No male participants repeated self-harm within the study period.
  • Ongoing parental concern was a significant predictor of subsequent DSH, whereas clinician risk assessment at the initial episode showed poor predictive value.

Conclusions:

  • Female adolescents exhibit higher rates of DSH repetition compared to males in this pediatric emergency setting.
  • Parental concern emerges as a more potent indicator of future DSH risk than initial clinical assessments.
  • All DSH presentations in children and adolescents warrant serious attention, particularly when accompanied by persistent parental worry.

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