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Fatal and non-fatal repetition of self-harm: Systematic review

  • David Owens (a1), Judith Horrocks (a1) and Allan House (a1)
Abstract
Background

Non-fatal self-harm frequently leads to non-fatal repetition and sometimes to suicide. We need to quantify these two outcomes of self-harm to help us to develop and test effective interventions.

Aims

To estimate rates of fatal and non-fatal repetition of self-harm.

Method

A systematic review of published follow-up data, from observational and experimental studies. Four electronic databases were searched and 90 studies met the inclusion criteria.

Results

Eighty per cent of studies found were undertaken in Europe, over one-third in the UK. Median proportions for repetition 1 year later were: 16% non-fatal and 2% fatal; after more than 9 years, around 7% of patients had died by suicide. The UK studies found particularly low rates of subsequent suicide.

Conclusions

After 1 year, non-fatal repetition rates are around 15%. The strong connection between self-harm and later suicide lies somewhere between 0.5% and 2% after 1 year and above 5% after 9 years. Suicide risk among self-harm patients is hundreds of times higher than in the general population.

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Copyright
Corresponding author
David Owens, Academic Unit of Psychiatry and Behavioural Sciences, University of Leeds, 15 Hyde Terrace, Leeds LS2 9LT, UK
Footnotes
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Declaration of interest

J.H.'s salary is paid by the mental health charity Leeds Mind from a research grant awarded by the UK National Lottery Charities Board.

Footnotes
References
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Fatal and non-fatal repetition of self-harm: Systematic review

  • David Owens (a1), Judith Horrocks (a1) and Allan House (a1)
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