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Deliberate self-harm in children and adolescents: an 11-year case note study

Published online by Cambridge University Press:  13 June 2014

Fiona McNicholas ,
John Fagan ,
Brid Tobin ,
Mairin Doherty  and
Neil Adamson
Fiona McNicholas
Affiliation:
Department of Child and Adolescent Psychiatry, Our Lady's Children's Hospital, Crumlin, Dublin 12, Ireland, Lucena Clinic, Rathgar and University College, Dublin
John Fagan
Affiliation:
Child and Adolescent Psychiatry, Lucena Clinic, Wicklow, Ireland
Brid Tobin
Affiliation:
Lucena Clinic, Rathgar and University College, Dublin, Ireland
Mairin Doherty
Affiliation:
Department of Child Psychiatry, Our Lady's Hospital for Sick Children, Crumlin, Dublin 12, Ireland
Neil Adamson
Affiliation:
Department of Child Psychiatry, Our Lady's Hospital for Sick Children, Crumlin, Dublin 12, Ireland
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Abstract

Objective: To retrospectively examine the case-notes of all children and adolescents admitted with deliberate self-harm (DSH) or suicidal ideation during the study period 1993-2003. The study aimed to identify underlying reasons why children and adolescents engage in DSH, and to identify common psychiatric, psychosocial and familial factors which may predispose or contribute to an individual's engagement in such behaviour.

Method: All children presenting to the hospital with DSH or suicidal ideation were identified and data collected from their case notes. A study specific questionnaire was designed to collect demographic details, details on clinical presentation, past attempts, comorbid psychiatry disorders, family history and family circumstances. Information was also recorded on hospital stay and discharge planning.

Results: During the 11-year period, 231 children presented with suicidal ideation or behaviour. The mean age was 12.85 with an age range from 6-17 years, with a female:male ratio of 2.5:1. Overdose was the most common method (81.2%) and paracetamol most commonly the drug of choice. More than half of the group (55.7%) expressed a wish to die. More than half (51.8%) had expressed suicidal ideation in the past, 31% had made a previous attempt, and 11.7% had been previously admitted. Of the children 8% presented with suicidal behaviour more than once over the study period. There was a family history of completed suicide in 6.6%.

Conclusion: Deliberate self-harm in young people is a significant public health problem in Ireland. During the period of this study, rates have continued to increase. There is an urgent need for national bodies such as the National Suicide Review Group to extend their focus to include those under age 18 and for services to be developed that might reduce DSH behaviours. More research is needed in the area of childhood suicidal behaviour.

Keywords

Deliberate self-harm (DSH)Suicidal ideation
Type
Original papers
Information
Irish Journal of Psychological Medicine , Volume 28 , Issue 4 , December 2011 , pp. 191 - 195
Copyright
Copyright © Cambridge University Press 2011

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References

1.World Health Organisation. World Health report 2001 mental health: New understanding, new hope. Geneva: World Health Reporting, 2001.Google Scholar
2.Corcoran, P, Keeley, HS, O'Sullivan, M, Perry, IJ. The incidence and repetition of attempted suicide in Ireland. Eur J Public health 2004; 14: 19–23.CrossRefGoogle ScholarPubMed
3.Reach Out. National Strategy for Action on Suicide Prevention. Department of Health and Children, 2005.Google Scholar
4.Central Statistics Office. Central Statistics Office, Skehard Road, Cork, Ireland.Google Scholar
5.National Suicide Research Foundation. National Registry of Deliberate Self Harm, Ireland. Annual Report, 2009.Google Scholar
6.Madge, N, Hewitt, Aet al.Deliberate Self-harm within an international community sample of young people: comparative findings from the Child and Adolescent Self-harm in Europe (CASE) Study. J Child Psychol Psych 2008; 49(6): 667–77.CrossRefGoogle ScholarPubMed
7.Hawton, K, Fagg, J, Simkin, S. Deliberate self-poisoning and self-injury in children and adolescents under 16 years of age in Oxford, 1976-1993. Br J Psychiatry 1996; 169: 202–208.CrossRefGoogle ScholarPubMed
8.Hawton, K, Harriss, L. Deliberate self-harm by under-15-year-olds: characteristics, trends and outcome. J Child Psychol Psych 2008; 49(4): 441–448.CrossRefGoogle ScholarPubMed
9.Hawton, K, Rodham, K, Evans, C, Weatherall, R. Deliberate self-harm survey in schools in England. BMJ 2002; 325: 1207–1211.CrossRefGoogle ScholarPubMed
10.Nakamura, JW, McLeod, CR, McDermott, JF. Temporal variation in adolescent suicide attempts. Suicide Life Threat Behav 1994; 24(4): 343–9.CrossRefGoogle ScholarPubMed
11.Morgan, S, Byrne, S, Boylan, C, McLearie, S, Fitzpatrick, C. Deliberate self-harm in young people: attendance at a paediatic emergency department. Ir Psych Med 2009; 26(3); 114–118.CrossRefGoogle Scholar
12.O'Sullivan, M, Fitzgerald, M. Suicidal ideation and acts of self-harm among Dublin school children. J Adolesc 1998; 21(4): 427–33.CrossRefGoogle ScholarPubMed
13.Evans, E, Hawton, K, Rodham, K. Suicidal phenomena and abuse in adolescents: a review of epidemiological studies. Child Abuse and Neglect 2005; 29: 45–58.CrossRefGoogle ScholarPubMed
14.Brent, et al.Psychiatric risk factors for adolescent suicide: a case-control study. J Am Acad Child Psych 1993; 32(3): 521–29.CrossRefGoogle ScholarPubMed
15.Foster, T, Gillespie, K, McLelland, R, Patterson, C. Risk factors for suicide independent of DSM-III-R Axis 1 disorder. Case control psychological autopsy study of Northern Ireland. Br J Psychiatry 1999; 175: 175–179.CrossRefGoogle Scholar
16.Hawton, K. Sex and suicide: Gender differences in suicidal behaviours. Br J Psychiatry 2000; 177: 484–485.CrossRefGoogle Scholar
17.Lewinsohn, PM, Rohde, P, Seeley, JR. Major depressive disorder in older adolescents: Prevalence, risk factors and clinical implications. Clin Psychol Rev 1998; 18(7): 765–94.CrossRefGoogle ScholarPubMed
18.Hawton, K, Arensman, E, Wasserman, D. The relationship between attempted suicide and suicide rates among young people in Europe. J Epidemiol Comm Health 1998; 52: 191–194.CrossRefGoogle Scholar
19.Fortune, S, Hawton, K. Deliberate self-harm in children and adolescents: a research update. Curr Op Psychiatry 2005; 18: 401–406.CrossRefGoogle ScholarPubMed
20.Sullivan, E, Arensman, E, Keeley, HS, Corcoran, P, Perry, IJ. Young People's Mental Health: A report of the results from the Lifestyle and Coping Survey. The National Suicide Research Foundation, 2004.Google Scholar
21.National Parasuicide Registry Annual Report 2003. National Suicide Research Foundation, 2004.Google Scholar
22.Hibell, et al. Alcohol and other Drug use Among Students in 35 European Countries. The ESPAD Report, 2003.Google Scholar
23.Hibell, et al. Substance use Among Students in 35 European Countries. The ESPAD Report, 2007.Google Scholar
24.Hawton, K, Fagg, J, Simkin, Set al.Deliberate Self Harm in adolescents in Oxford. J Adoles 2000; 23(1): 47–55.CrossRefGoogle ScholarPubMed
25.Baker, AW, Duncan, SP. Child sexual abuse: a study of prevalence in Great Britain. Child Abuse and Neglect 1985; 9: 457–67.CrossRefGoogle ScholarPubMed
26.Bruffaerts, R, Demyttenaere, Ket al.Childhood adversities as risk factors for onset and persistence of suicidal behaviour. Br J Psych 2010; 197: 20–27.CrossRefGoogle ScholarPubMed
27.Klonsky, ED. The Functions of self-injury in young adults who cut themselves: clarifying the evidence of affect regulation. Psychiatry Res 2009; 166(2-3): 260–268.CrossRefGoogle ScholarPubMed
28.Bergen, H, Hawton, K. Variations in time of hospital presentation for deliberate self-harm and their implications for clinical services. J Affect Disord 2007 Mar; 98(3): 227–37.CrossRefGoogle ScholarPubMed
29.McNicholas, F, O'Sullivan, M, Ruth, Lennon, Doherty, M, Adamson, N. Deliberate self-harm (DSH) out of hour's presentations. Ir J Psychol Med 2010; 27(1).CrossRefGoogle ScholarPubMed
30.Nock, MK. Actions speak louder than words: An elaborated theoretical model of the social functions of self-injury and other harmful behaviours. Appl Prev Psychol 2008; 12(4): 159–168.CrossRefGoogle Scholar
31.Haw, C, Hawton, K, Houston, K, Townsend, E. Psychiatric and Personality disorders in deliberate self-harm patients. Br J Psych 2001; 178: 48–54.CrossRefGoogle ScholarPubMed
32.National Task Force on Suicide. Publication of the final report of the National Task Force on Suicide. Dept of Health and Children, 1998. www.dohc.ieGoogle Scholar
33.Wasserman, D, Carli, Vet al.Saving and Empowering Young Lives in Europe (SEYLE): a randomised controlled trial. BMC Public Health 2010; 10: 192.CrossRefGoogle Scholar
34.Hawton, K, Townsend, E, Arensman, Eet al.Psychosocial and pharmacological treatments for deliberate self harm (Review). The Cochrane Library 2009, Issue 1.Google Scholar