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Shared characteristics of suicides and other unnatural deaths following non-fatal self-harm? A multicentre study of risk factors.
- Source :
- Psychological Medicine; Apr2012, Vol. 42 Issue 4, p727-741, 15p
- Publication Year :
- 2012
-
Abstract
- BackgroundMortality, including suicide and accidents, is elevated in self-harm populations. Although risk factors for suicide following self-harm are often investigated, rarely have those for accidents been studied. Our aim was to compare risk factors for suicide and accidents.MethodA prospective cohort (n=30 202) from the Multicentre Study of Self-harm in England, 2000–2007, was followed up to 2010 using national death registers. Risk factors for suicide (intentional self-harm and undetermined intent) and accidents (narcotic poisoning, non-narcotic poisoning, and non-poisoning) following the last hospital presentation for self-harm were estimated using Cox models.ResultsDuring follow-up, 1833 individuals died, 378 (20.6%) by suicide and 242 (13.2%) by accidents. Independent predictors of both suicide and accidents were: male gender, age ⩾35 years (except accidental narcotic poisoning) and psychiatric treatment (except accidental narcotic poisoning). Factors differentiating suicide from accident risk were previous self-harm, last method of self-harm (twofold increased risks for cutting and violent self-injury versus self-poisoning) and mental health problems. A risk factor specific to accidental narcotic poisoning was recreational/illicit drug problems, and a risk factor specific to accidental non-narcotic poisoning and non-poisoning accidents was alcohol involvement with self-harm.ConclusionsThe similarity of risk factors for suicide and accidents indicates common experiences of socio-economic disadvantage, life problems and psychopathology resulting in a variety of self-destructive behaviour. Of factors associated with the accidental death groups, those for non-narcotic poisoning and other accidents were most similar to suicide; differences seemed to be related to criteria coroners use in reaching verdicts. Our findings support the idea of a continuum of premature death. [ABSTRACT FROM PUBLISHER]
Details
- Language :
- English
- ISSN :
- 00332917
- Volume :
- 42
- Issue :
- 4
- Database :
- Complementary Index
- Journal :
- Psychological Medicine
- Publication Type :
- Academic Journal
- Accession number :
- 74555037
- Full Text :
- https://doi.org/10.1017/S0033291711001747