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First episode of self-harm in older age: a report from the 10-year prospective Manchester Self-Harm project.
- Source :
-
The Journal of clinical psychiatry [J Clin Psychiatry] 2011 Jun; Vol. 72 (6), pp. 737-43. - Publication Year :
- 2011
-
Abstract
- Objective: Self-harm is closely related to completed suicide, especially in older age. As empirical research of self-harm in older age is scarce, with no studies confined to first-ever episodes in older age, we examined the clinical characteristics and the risk of repetition in first-ever self-harm in older age.<br />Method: The Manchester Self-Harm (MaSH) project, a prospective cohort study, gathered data from September 1, 1997, through August 31, 2007, for individuals presenting with self-harm at emergency departments of 3 large hospitals in North West England. The characteristics of older patients (aged ≥ 55 years) who presented with a first-ever episode of self-harm are described and compared to those of middle-aged patients (35-54 years) presenting with a first-ever episode of self-harm. Following each episode, the MaSH form, a standard assessment form developed for the MaSH project, was completed by a clinician. Potential risk factors for repetition were examined by Cox regression analyses.<br />Results: A total of 374 older patients and 1,937 middle-aged patients presented with a first-ever episode of self-harm. The circumstances at the time of self-harm suggested higher suicidal intent in older age. In comparison with middle-aged patients, the rate of repetition in older-aged patients was lower (15.4% versus 11.8%, respectively; hazard ratio for older age = 0.65; 95% CI, 0.45-0.93; P = .019), although repetition was more often fatal among the older group (3.3% versus 13.6%, respectively; P = .009). The most important predictor of repetition in older age, ie, physical health problems, had no predictive value in middle-aged patients, whereas psychiatric characteristics had little impact on the risk of repetition in old age.<br />Conclusions: High suicidal intent and different predictors of repetition in first-ever self-harm in older age highlight the need for age-specific interventions beyond the scope of psychiatric care alone.<br /> (© Copyright 2011 Physicians Postgraduate Press, Inc.)
- Subjects :
- Adult
Age Factors
Age of Onset
Aged
Aged, 80 and over
Chi-Square Distribution
Emergency Service, Hospital
England epidemiology
Female
Hospitalization statistics & numerical data
Humans
Male
Middle Aged
Proportional Hazards Models
Prospective Studies
Recurrence
Risk Factors
Self-Injurious Behavior diagnosis
Self-Injurious Behavior epidemiology
Statistics, Nonparametric
Suicide, Attempted psychology
Self-Injurious Behavior psychology
Subjects
Details
- Language :
- English
- ISSN :
- 1555-2101
- Volume :
- 72
- Issue :
- 6
- Database :
- MEDLINE
- Journal :
- The Journal of clinical psychiatry
- Publication Type :
- Academic Journal
- Accession number :
- 21733475
- Full Text :
- https://doi.org/10.4088/JCP.10m06501