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Population-based study of medically treated self-inflicted injuries

Published online by Cambridge University Press:  21 May 2015

Ian Colman ,
Niko Yiannakoulias ,
Don Schopflocher ,
Lawrence W. Svenson ,
Rhonda J. Rosychuk ,
Brian H. Rowe  and
ED Atlas Group
Ian Colman
Affiliation:
Department of Psychiatry, University of Cambridge, Cambridge, United Kingdom
Niko Yiannakoulias
Affiliation:
Alberta Health and Wellness, Edmonton, Alta
Don Schopflocher
Affiliation:
Alberta Health and Wellness, Edmonton, Alta
Lawrence W. Svenson
Affiliation:
Alberta Health and Wellness, Edmonton, Alta
Rhonda J. Rosychuk
Affiliation:
Department of Pediatrics, University of Alberta, Edmonton, Alta
Brian H. Rowe*
Affiliation:
Division of Emergency Medicine, University of Alberta, Edmonton, Alta
ED Atlas Group
Affiliation:
See screened box at end of the article for list of the other members of the ED Atlas Group.
*
Division of Emergency Medicine, University of Alberta, 1G1.43 Walter Mackenzie Health Sciences Centre, 8440 — 112 St., Edmonton AB T6G 2B7; 780 407-6761, fax 780 407-3982, [email protected]

Abstract

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Objective:

Self-inflicted injury is commonly seen in emergency departments (EDs). It may be a precursor to death by suicide. The objective of this study was to examine the epidemiology of self-inflicted injury presentations to EDs in the province of Alberta.

Methods:

Self-inflicted injury records for the 3 fiscal years 1998/99 to 2000/01 were accessed from the Ambulatory Care Classification System, a database that captures all ED encounters in the province of Alberta. Available data for each case included demographic details, location and time of visit, diagnoses and procedures.

Results:

There were 22 396 self-inflicted injury presentations to Alberta EDs during the study period. Self-inflicted injury rates were higher in females, younger patients, those on social services and those with Aboriginal treaty status. There were higher rates of return visits in the year following the self-inflicted injury than in other patient groups. Data showed regional variation. Trends could be seen in the timing of self-inflicted injury presentations by hour of day, day of week, and month of year.

Conclusions:

Self-inflicted injury is common, with particularly high rates demonstrated among marginalized populations. This study provides comprehensive data on those who present with self-inflicted injuries, and can be used to guide further treatment, research and evaluation for this population.

Keywords

self-injurious behaviourattempted suicideprevalenceepidemiology
Type
EM Advances • Innovations en MU
Information
Canadian Journal of Emergency Medicine , Volume 6 , Issue 5 , September 2004 , pp. 313 - 320
Copyright
Copyright © Canadian Association of Emergency Physicians 2004

References

1.Weissman, MM, Bland, RC, Canino, GJ, Greenwald, S, Hwu, HG, Joyce, PR, et al. Prevalence of suicide ideation and suicide attempts in nine countries. Psychol Med 1999;29(1):9–17.Google Scholar
2.International Classification of Diseases, 9th rev, 3rd ed. (Clinical Modification). Los Angeles: Practice Management Information Corporation; 1989.Google Scholar
3.Dyck, RJ, Bland, RC, Newman, SC, Orn, H.Suicide attempts and psychiatric disorders in Edmonton. Acta Psychiatr Scand Suppl 1988;338:64–71.Google Scholar
4.Thompson, AH, Bland, RC.Social dysfunction and mental illness in a community sample. Can J Psychiatry 1995;40(1):15–20.CrossRefGoogle Scholar
5.Suominen, K, Henriksson, M, Suokas, J, Isometsa, E, Ostamo, A, Lonnqvists, J.Mental disorders and comorbidity in attempted suicide. Acta Psychiatr Scand 1996;94(4):234–40.Google Scholar
6.Goldney, RD.A global view of suicidal behaviour. Emerg Med (Fremantle) 2002;14(1):24–34.CrossRefGoogle ScholarPubMed
7.Colman, I, Newman, SC, Schopflocher, D, Bland, RC, Dyck, RJ.A multivariate study of predictors of repeat parasuicide. Acta Psychiatr Scand 2004;109(4):306–12.CrossRefGoogle ScholarPubMed
8.Hawton, K, Fagg, J.Suicide, and other causes of death, following attempted suicide. Br J Psychiatry 1988;152:359–66.CrossRefGoogle ScholarPubMed
9.Harris, EC, Barraclough, B.Excess mortality of mental disorder. Br J Psychiatry 1998;173:11–53.CrossRefGoogle ScholarPubMed
10.Hall, DJ, O’Brien, F, Stark, C, Pelosi, A, Smith, H.Thirteen-year follow-up of deliberate self-harm, using linked data. Br J Psychiatry 1998;172:239–42.CrossRefGoogle ScholarPubMed
11.Ostamo, A, Lonnqvist, J.Excess mortality of suicide attempters. Soc Psychiatry Psychiatr Epidemiol 2001;36(1):29–35.CrossRefGoogle ScholarPubMed
12.Owens, D, Horrocks, J, House, A.Fatal and non-fatal repetition of self-harm: systematic review. Br J Psychiatry 2002;181:193–9.CrossRefGoogle ScholarPubMed
13.Schmidtke, A, Bille-Brahe, U, DeLeo, D, Kerkhof, A, Bjerke, T, Crepet, Pet al. Attempted suicide in Europe: rates, trends and sociodemographic characteristics of suicide attempters during the period 1989–1992. Results of the WHO/EURO Multicentre Study on Parasuicide. Acta Psychiatr Scand 1996;93(5):327–38.CrossRefGoogle ScholarPubMed
14.MoScicki, EK, O’Carroll, P, Rae, DS, Locke, BZ, Roy, A, Regier, DA.Suicide attempts in the Epidemiologic Catchment Area Study. Yale J Biol Med 1988;61(3):259–68.Google Scholar
15.Spicer, RS, Miller, TR.Suicide acts in 8 states: incidence and case fatality rates by demographics and method. Am J Public Health 2000;90(12):1885–91.Google ScholarPubMed
16.Indian and Northern Affairs Canada. Terminology. Available: www.ainc-inac.gc.ca/pr/info/tln_e.html (accessed 2003 July 25).Google Scholar
17.Cleveland, WS, Devlin, SJ.Locally weighted regression: an approach to regression analysis by local fitting. J Am Stat Assoc 1988;83:596–610.CrossRefGoogle Scholar
18.Platt, S, Bille-Brahe, U, Kerkhof, A, Schmidtke, A, Bjerke, T, Crepet, P, et al. Parasuicide in Europe: the WHO/EURO Multicentre Study on Parasuicide. I. Introduction and preliminary analysis for 1989. Acta Psychiatr Scand 1992;85(2):97–104.CrossRefGoogle ScholarPubMed
19.Welch, SS.A review of the literature on the epidemiology of parasuicide in the general population. Psychiatr Serv 2001;52 (3):368–75.Google Scholar
20.Rhoades, ER.The health status of American Indian and Alaska native males. Am J Public Health 2003;93(5):774–8.Google Scholar
21.Trovato, F.Canadian Indian mortality during the 1980s. Soc Biol 2000;47(1–2):135–45.Google ScholarPubMed
22.Mahoney, MC, Michalek, AM.Health status of American Indians/Alaska Natives: general patterns of mortality. Fam Med 1998;30(3):190–5.Google ScholarPubMed
23.Malchy, B, Enns, MW, Young, TK, Cox, BJ.Suicide among Manitoba’s aboriginal people, 1988 to 1994. CMAJ 1997;156(8): 1133–8.Google ScholarPubMed
24.Royal Commission on Aboriginal Peoples. Choosing life: special report on suicide among Aboriginal people. Ottawa (ON): Royal Commission on Aboriginal Peoples; 1995.Google Scholar
25.Colman, I, Dryden, DM, Thompson, AH, Chahal, AM, Borden, K, Rowe, BH, et al. Utilization of the emergency department after self-inflicted injury. Acad Emerg Med 2004;11(2):136–42.Google Scholar
26.Jessen, G, Andersen, K, Arensman, E, Bille-Brahe, U, Crepet, P, DeLeo, D, et al. Temporal fluctuations and seasonality in attempted suicide in Europe. Arch Suicide Res 1999;5(1):57–69.Google Scholar
27.Ho, BK, Kua, EH, Hong, C.Temporal variation in parasuicide among Singaporean Chinese. Aust N Z J Psychiatry 1998;32(4): 500–3.CrossRefGoogle ScholarPubMed
28.Preti, A.The influence of seasonal change on suicidal behaviour in Italy. J Affect Disord 1997;44(2–3):123–30.CrossRefGoogle ScholarPubMed
29.Barker, A, Hawton, K, Fagg, J, Jennison, C.Seasonal and weather factors in parasuicide. Br J Psychiatry 1994;165(3):375–80.Google Scholar
30.Masterton, G.Monthly and seasonal variation in parasuicide: a sex difference. Br J Psychiatry 1991;158:155–7.Google Scholar
31.Meehan, PJ, Lamb, JA, Saltzman, LE, O’Carroll, PW.Attempted suicide among young adults: progress toward a meaningful estimate of prevalence. Am J Psychiatry 1992;149(1):41–4.Google Scholar
32.O’Donnell, I, Farmer, R.The limitations of official suicide statistics. Br J Psychiatry 1995;166(4):458–61.Google Scholar
33.Ohberg, A, Lonnqvist, J.Suicides hidden among undetermined deaths. Acta Psychiatr Scand 1998;98(3):214–8.Google Scholar
34.Rhodes, AE, Links, PS, Streiner, DL, Dawe, I, Cass, D, Janes, S.Do hospital E-codes consistently capture suicidal behaviour? Chronic Dis Can 2002;23(4):139–45.Google ScholarPubMed
35.Sellar, C, Goldacre, MJ, Hawton, K.Reliability of routine hospital data on poisoning as measures of deliberate self poisoning in adolescents. J Epidemiol Community Health 1990;44(4):313–5.CrossRefGoogle ScholarPubMed
36.Iribarren, C, Sidney, S, Jacobs, DR Jr, Weisner, C.Hospitalization for suicide attempt and completed suicide: epidemiological features in a managed care population. Soc Psychiatry Psychiatr Epidemiol 2000;35(7):288–96.CrossRefGoogle Scholar