Skip to main content
×
×
Home

Repetition of deliberate self-harm and subsequent suicide risk: Long-term follow-up study of 11 583 patients

  • Daniel Louis Zahl (a1) and Keith Hawton (a1)
Abstract
Background

Repetition of deliberate self-harm (DSH) is a risk factor for suicide. Little information is available on the risk for specific groups of people who deliberately harm themselves repeatedly.

Aims

To investigate the long-term risk of suicide associated with repetition of DSH by gender, age and frequency of repetition.

Method

A mortality follow-up study to the year 2000 was conducted on 11583 people who presented to the general hospital in Oxford between 1978 and 1997. Repetition of DSH was determined from reported episodes prior to the index episode and episodes presenting to the same hospital during the follow-up period. Deaths were identified through national registers.

Results

Thirty-nine percent of patients repeated the DSH. They were at greater relative risk of suicide than the single-episode DSH group (2.24; 95% CI 1.77–2.84). The relative risk of suicide in the repeated DSH group compared with the single-episode DSH group was greater in females (3.5; 95% C11.3–2.4) than males (1.8; 95% C1 2.3–5.3) and was inversely related to age (up to 54 years). Suicide risk increased further with multiple repeat episodes of DSH in females.

Conclusions

Repetition of DSH is associated with an increased risk of suicide in males and females. Repetition may be a better indicator of risk in females, especially young females.

    • Send article to Kindle

      To send this article to your Kindle, first ensure no-reply@cambridge.org is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about sending to your Kindle. Find out more about sending to your Kindle.

      Note you can select to send to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be sent to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

      Find out more about the Kindle Personal Document Service.

      Repetition of deliberate self-harm and subsequent suicide risk: Long-term follow-up study of 11 583 patients
      Available formats
      ×
      Send article to Dropbox

      To send this article to your Dropbox account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your <service> account. Find out more about sending content to Dropbox.

      Repetition of deliberate self-harm and subsequent suicide risk: Long-term follow-up study of 11 583 patients
      Available formats
      ×
      Send article to Google Drive

      To send this article to your Google Drive account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your <service> account. Find out more about sending content to Google Drive.

      Repetition of deliberate self-harm and subsequent suicide risk: Long-term follow-up study of 11 583 patients
      Available formats
      ×
Copyright
Corresponding author
Professor Keith Hawton, Centre for Suicide Research, University Department of Psychiatry, Warneford Hospital, Oxford OX3 7JX, UK. E-mail: keith.hawton@psych.ox.ac.uk
Footnotes
Hide All

Declaration of interest

None. Funding detailed in Acknowledgements.

Footnotes
References
Hide All
Adelstein, A. & Mardon, C. (1975) Suicides 1961—74. Population Trends, 2, 1319.
Bancroft, J. & Marsack, P. (1977) The repetitiveness of self-poisoning and self-injury. British Journal of Psychiatry, 131, 394399.
Charlton, J., Kelly, S., Dunnell, K., et al (1992) Trends in suicide deaths in England and Wales. Population Trends, 69, 1016.
Hawton, K. (1987) Assessment of suicide risk. British Journal of Psychiatry, 150, 145153.
Hawton, K. & Fagg, J. (1988) Suicide, and other causes of death, following attempted suicide. British Journal of Psychiatry, 152, 359366.
Hawton, K. & Fagg, J. (1992) Trends in deliberate self poisoning and self injury in Oxford, 1976—90. BMJ, 304, 14091411.
Hawton, K., Fagg, J., Simkin, S., et al (1997) Trends in deliberate self-harm in Oxford, 1985—1995. Implications for clinical services and the prevention of suicide. British Journal of Psychiatry, 171, 556560.
Hawton, K., Zahl, D. & Weatherall, R. (2003) Suicide following deliberate self-harm: long term follow-up study of patients who presented to a general hospital. British Journal of Psychiatry, 182, 537542.
Kreitman, N. & Casey, P. (1988) Repetition of parasuicide: an epidemiological and clinical study. British Journal of Psychiatry, 153, 792800.
Morgan, H. G., Barton, J., Pottle, S., et al (1976) Deliberate self-harm: a follow-up study of 279 patients. British Journal of Psychiatry, 128, 361368.
Owens, D., Dennis, M., Read, S., et al (1994) Outcome of deliberate self-poisoning. An examination of risk factors for repetition. British Journal of Psychiatry, 165 797801.
Owens, D., Horrocks, J. & House, A. (2002) Fatal and non-fatal repetition of self-harm. Systematic review British Journal of Psychiatry, 181, 193199.
Pocock, S., Clayton, T. & Altman, D. (2002) Survival plots of time-to-event out comes in clinical trials: good practice and pitfalls. Lancet, 359, 16861689.
Sakinofsky, I. (2000) Repetition of suicidal behaviour. In The International Handbook of Suicide and Attempted Suicide (eds Hawton, K. & Van Heeringen, K.), pp. 385404. Chichester: John Wiley & Sons.
Tejedor, M. C., Diaz, A., Castillon, J. J., et al (1999) Attempted suicide: repetition and survival-findings of a follow-up study. Acta Psychiatrica Scandinavica, 100, 205211.
Wilkinson, G. & Smeeton, N. (1987) The repetition of parasuicide in Edinburgh 1980—1981. Social Psychiatry, 22, 1419.
Recommend this journal

Email your librarian or administrator to recommend adding this journal to your organisation's collection.

The British Journal of Psychiatry
  • ISSN: 0007-1250
  • EISSN: 1472-1465
  • URL: /core/journals/the-british-journal-of-psychiatry
Please enter your name
Please enter a valid email address
Who would you like to send this to? *
×

Metrics

Altmetric attention score

Full text views

Total number of HTML views: 0
Total number of PDF views: 29 *
Loading metrics...

Abstract views

Total abstract views: 91 *
Loading metrics...

* Views captured on Cambridge Core between 3rd January 2018 - 21st April 2018. This data will be updated every 24 hours.

Repetition of deliberate self-harm and subsequent suicide risk: Long-term follow-up study of 11 583 patients

  • Daniel Louis Zahl (a1) and Keith Hawton (a1)
Submit a response

eLetters

No eLetters have been published for this article.

×

Reply to: Submit a response


Your details


Conflicting interests

Do you have any conflicting interests? *