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Thirteen-year follow-up of deliberate self-harm, using linked data

Published online by Cambridge University Press:  02 January 2018

David J. Hall ,
Fiona O'Brien ,
Cameron Stark ,
Antony Pelosi  and
Helen Smith
David J. Hall
Affiliation:
Crichton Royal Hospital, Dumfries
Fiona O'Brien
Affiliation:
Information and Statistics Division, NHS in Scotland
Cameron Stark*
Affiliation:
Highland Health Board, Inverness
Antony Pelosi
Affiliation:
Lanarkshire Healthcare NHS Trust
Helen Smith
Affiliation:
Argyll and Clyde Health Board
*
Cameron Stark, Consultant in Public Health Medicine, Highland Health Board. Beechwood Park, Inverness IV2 3HG
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Abstract

Background

We describe a national cohort of individuals surviving an episode of deliberate self-harm (DSH). Subsequent admissions for DSH and mortality over the following 13 years were studied.

Method

In 1981, 8304 individuals were discharged from Scottish general hospitals with a diagnosis of attempted suicide (E950–959). They were followed-up to the end of 1994 using the Scottish Linked Data Set. Mortality was compared to the Scottish population using person-years analysis.

Results

2624 people (31.6%) were readmitted with further episodes of DSH. The median number of readmissions was I, range 1–137. The observed: expected ratio for all-cause mortality was 2.26 (95% CI 2.13–2.26). One hundred and sixty-eight people (2%) died from suicide, and 46 (0.6%) from undetermined causes. The observed: expected ratio for suicide plus undetermined deaths was 12.17 (95% CI 10.64-13.91). Accidental deaths in men and homicide deaths in men and women were elevated. The pattern of deaths from other causes suggested that alcohol misuse was a contributory factor.

Conclusions

People admitted to general hospitals in Scotland after attempted suicide are at high risk of readmission for further episodes of DSH. Long-term follow-up of such large cohorts is impractical, but services should review the scope for intervention in alcohol misuse following DSH.

Type
Papers
Information
The British Journal of Psychiatry , Volume 172 , Issue 3 , March 1998 , pp. 239 - 242
Copyright
Copyright © 1998 The Royal College of Psychiatrists 

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