Patients with first versus multiple episodes of self-harm: how do their profiles differ?

Area of Science:

• Psychiatry
• Public Health
• Epidemiology

Background:

• Self-harm (SH) is a significant predictor of future suicide attempts and mortality.
• Individuals with recurrent self-harm behaviors face elevated suicide risks.
• Understanding factors contributing to SH repetition is vital for risk assessment and intervention.

Purpose of the Study:

• To compare characteristics of first-time versus multiple self-harm episodes.
• To identify key factors associated with repeated self-harm in a large patient sample.

Main Methods:

• Utilized data from the French-speaking Swiss program for monitoring self-harm.
• Collected psychiatric assessment data from adult patients admitted for SH across four Swiss hospitals (December 2016 - October 2019).

Main Results:

• 1730 episodes of self-harm were analyzed.
• Multiple episodes were associated with personality disorders (overrepresented) and anxiety disorders (underrepresented).
• Invalidity insurance and prior psychiatric care were more frequent in patients with multiple SH episodes.

Conclusions:

• Personality disorders and invalidity insurance status are risk factors for repeated self-harm.
• These patient groups require targeted interventions to mitigate risks associated with recurrent self-harm.