Skip to main content
Top
Published in: Social Psychiatry and Psychiatric Epidemiology 2/2016

Open Access 01-02-2016 | Original Paper

Young people who self-harm: a prospective 1-year follow-up study

Authors: Madiha Majid, Maria Tadros, George Tadros, Swaran Singh, Matthew R. Broome, Rachel Upthegrove

Published in: Social Psychiatry and Psychiatric Epidemiology | Issue 2/2016

Login to get access

Abstract

Purpose

To explore repetition, service provision and service engagement following presentation of young people to emergency services with self-harm.

Methods

969 patients who presented to accident and emergency services after self-harm were followed up prospectively for a period of 1 year. Data on rates, method, clinical history, initial service provision, engagement and repetition (defined as re-presenting to emergency services with further self-harm) were gathered from comprehensive electronic records.

Results

Young people were less likely to repeat self-harm compared to those aged 25 and above. A psychiatric history and a history of childhood trauma were significant predictors of repetition. Young people were more likely to receive self-help as their initial service provision, and less likely to receive acute psychiatric care or a hospital admission. There were no differences in engagement with services between young people and those aged 25 and above.

Conclusion

Younger individuals may be less vulnerable to repetition, and are less likely to represent to services with repeated self-harm. All young people who present with self-harm should be screened for mental illness and asked about childhood trauma. Whilst young people are less likely to be referred to psychiatric services, they do attend when referred. This may indicate missed opportunity for intervention.
Literature
4.
go back to reference Cooper J, Kapur N, Webb R, Lawlor M, Guthrie E, Mackway-Jones K, Appleby L (2005) Suicide after deliberate self-harm: a 4-year cohort study. Am J Psychiatry 162:297–303CrossRefPubMed Cooper J, Kapur N, Webb R, Lawlor M, Guthrie E, Mackway-Jones K, Appleby L (2005) Suicide after deliberate self-harm: a 4-year cohort study. Am J Psychiatry 162:297–303CrossRefPubMed
9.
10.
go back to reference Hawton K, Bergen H, Casey D, Simkin S, Palmer B, Cooper J, Kapur N, Horrocks J, House A, Lilley R, Noble R, Owens D (2007) Self-harm in England: a tale of three cities. Multicentre study of self-harm. Soc Psychiatry Psychiatr Epidemiol 42:513. doi:10.1007/s00127-007-0199-7 CrossRefPubMed Hawton K, Bergen H, Casey D, Simkin S, Palmer B, Cooper J, Kapur N, Horrocks J, House A, Lilley R, Noble R, Owens D (2007) Self-harm in England: a tale of three cities. Multicentre study of self-harm. Soc Psychiatry Psychiatr Epidemiol 42:513. doi:10.​1007/​s00127-007-0199-7 CrossRefPubMed
14.
go back to reference Mars B, Heron J, Crane C, Hawton K, Lewis G, Macleod J, Tilling K, Gunnell D (2014) Clinical and social outcomes of adolescent self harm: population based birth cohort study. BMJ 349:g5954PubMedCentralCrossRefPubMed Mars B, Heron J, Crane C, Hawton K, Lewis G, Macleod J, Tilling K, Gunnell D (2014) Clinical and social outcomes of adolescent self harm: population based birth cohort study. BMJ 349:g5954PubMedCentralCrossRefPubMed
15.
go back to reference Hawton K, Harriss L, Hall S, Simkin S, Bale E, Bond A (2003) Deliberate self-harm in Oxford, 1990–2000: a time of change in patient characteristics. Psychol Med 33:987–995CrossRefPubMed Hawton K, Harriss L, Hall S, Simkin S, Bale E, Bond A (2003) Deliberate self-harm in Oxford, 1990–2000: a time of change in patient characteristics. Psychol Med 33:987–995CrossRefPubMed
19.
20.
go back to reference Rhodes AE, Bethell J, Spence J, Links PS, Streiner DL, Jaakkimainen RL (2008) Age-sex differences in medicinal self-poisonings: a population-based study of deliberate intent and medical severity. Soc Psychiatry Psychiatr Epidemiol 43:642–652. doi:10.1007/s00127-008-0349-6 CrossRefPubMed Rhodes AE, Bethell J, Spence J, Links PS, Streiner DL, Jaakkimainen RL (2008) Age-sex differences in medicinal self-poisonings: a population-based study of deliberate intent and medical severity. Soc Psychiatry Psychiatr Epidemiol 43:642–652. doi:10.​1007/​s00127-008-0349-6 CrossRefPubMed
21.
go back to reference Hawton K, Bergen H, Cooper J, Turnbull P, Waters K, Ness J, Kapur N (2015) Suicide following self-harm: findings from the Multicentre Study of self-harm in England, 2000-2012. J Affect Disord 175:147–151CrossRefPubMed Hawton K, Bergen H, Cooper J, Turnbull P, Waters K, Ness J, Kapur N (2015) Suicide following self-harm: findings from the Multicentre Study of self-harm in England, 2000-2012. J Affect Disord 175:147–151CrossRefPubMed
24.
go back to reference Hawton K, Harriss L (2007) Deliberate self-harm in young people: characteristics and subsequent mortality in a 20-year cohort of patients presenting to hospital. J Clin Psychiatry 68:1574–1583CrossRefPubMed Hawton K, Harriss L (2007) Deliberate self-harm in young people: characteristics and subsequent mortality in a 20-year cohort of patients presenting to hospital. J Clin Psychiatry 68:1574–1583CrossRefPubMed
26.
go back to reference Tadros G, Salama RA, Kingston P, Mustafa N, Johnson E, Pannell R, Hashmi M (2013) Impact of an integrated rapid response psychiatric liaison team on quality improvement and cost savings: the Birmingham RAID model. The Psychiatrist 37:4–10. doi:10.1192/pb.bp.111.037366 CrossRef Tadros G, Salama RA, Kingston P, Mustafa N, Johnson E, Pannell R, Hashmi M (2013) Impact of an integrated rapid response psychiatric liaison team on quality improvement and cost savings: the Birmingham RAID model. The Psychiatrist 37:4–10. doi:10.​1192/​pb.​bp.​111.​037366 CrossRef
32.
go back to reference Cooper J, Murphy E, Webb R, Hawton K, Bergen H, Waters K, Kapur N (2010) Ethnic differences in self-harm, rates, characteristics and service provision: three-city cohort study. Br J Psychiatry 197:212–218CrossRefPubMed Cooper J, Murphy E, Webb R, Hawton K, Bergen H, Waters K, Kapur N (2010) Ethnic differences in self-harm, rates, characteristics and service provision: three-city cohort study. Br J Psychiatry 197:212–218CrossRefPubMed
33.
go back to reference Al-Sharifi A, Krynicki CR, Upthegrove R (2015) Self-harm and ethnicity: a systematic review. Int J Soc Psychiatry 61(6):600–612CrossRefPubMed Al-Sharifi A, Krynicki CR, Upthegrove R (2015) Self-harm and ethnicity: a systematic review. Int J Soc Psychiatry 61(6):600–612CrossRefPubMed
34.
go back to reference Larkin C, Di Blasi Z, Arensman E (2014) Risk factors for repetition of self- harm: a systematic review of prospective hospital- based studies. PLoS ONE 9:e84282PubMedCentralCrossRefPubMed Larkin C, Di Blasi Z, Arensman E (2014) Risk factors for repetition of self- harm: a systematic review of prospective hospital- based studies. PLoS ONE 9:e84282PubMedCentralCrossRefPubMed
35.
go back to reference Carroll R, Metcalfe C, Gunnell D (2014) Hospital presenting self-harm and risk of fatal and non-fatal repetition: systematic review and meta-analysis. PLoS ONE 9:e89944PubMedCentralCrossRefPubMed Carroll R, Metcalfe C, Gunnell D (2014) Hospital presenting self-harm and risk of fatal and non-fatal repetition: systematic review and meta-analysis. PLoS ONE 9:e89944PubMedCentralCrossRefPubMed
36.
go back to reference Hawton K, Bergen H, Kapur N, Cooper J, Steeg S, Ness J, Waters K (2012) Repetition of self-harm and suicide following self-harm in children and adolescents: findings from the Multicentre Study of Self-harm in England. J Child Psychol Psychiatry 53:1212–1219CrossRefPubMed Hawton K, Bergen H, Kapur N, Cooper J, Steeg S, Ness J, Waters K (2012) Repetition of self-harm and suicide following self-harm in children and adolescents: findings from the Multicentre Study of Self-harm in England. J Child Psychol Psychiatry 53:1212–1219CrossRefPubMed
37.
go back to reference Haw C, Bergen H, Casey D, Hawton K (2007) Repetition of deliberate self- harm: a study of the characteristics and subsequent deaths in patients presenting to a general hospital according to extent of repetition. Suicide Life Threat 37:379CrossRef Haw C, Bergen H, Casey D, Hawton K (2007) Repetition of deliberate self- harm: a study of the characteristics and subsequent deaths in patients presenting to a general hospital according to extent of repetition. Suicide Life Threat 37:379CrossRef
40.
go back to reference Oude-Voshaar RC, Cooper J, Murphy E, Steeg S, Kapur N, Purandare NB (2011) First episode of self-harm in older age: a report from the 10-year prospective Manchester self-harm project. J Clin Psychiatry 72:737. doi:10.4088/JCP.10m06501 CrossRefPubMed Oude-Voshaar RC, Cooper J, Murphy E, Steeg S, Kapur N, Purandare NB (2011) First episode of self-harm in older age: a report from the 10-year prospective Manchester self-harm project. J Clin Psychiatry 72:737. doi:10.​4088/​JCP.​10m06501 CrossRefPubMed
41.
43.
go back to reference McGorry P, Bates T, Birchwood M (2013) Designing youth mental health services for the 21st century: examples from Australia, Ireland and the UK. Br J Psychiatry Suppl 54:s30–s35CrossRefPubMed McGorry P, Bates T, Birchwood M (2013) Designing youth mental health services for the 21st century: examples from Australia, Ireland and the UK. Br J Psychiatry Suppl 54:s30–s35CrossRefPubMed
45.
go back to reference Kapur N, Steeg S, Turnbull P, Webb R, Bergen H, Hawton K, Geulayov G, Townsend E, Ness J, Waters K, Cooper J (2015) Hospital management of suicidal behaviour and subsequent mortality: a prospective cohort study. Lancet Psychiatry 2:809–816CrossRefPubMed Kapur N, Steeg S, Turnbull P, Webb R, Bergen H, Hawton K, Geulayov G, Townsend E, Ness J, Waters K, Cooper J (2015) Hospital management of suicidal behaviour and subsequent mortality: a prospective cohort study. Lancet Psychiatry 2:809–816CrossRefPubMed
46.
go back to reference Gunnell D, Hawton K, Ho D, Evans J, O’Connor S, Potokar J, Donovan J, Kapur N (2008) Hospital admissions for self harm after discharge from psychiatric inpatient care: cohort study. BMJ 337:1331–1334. doi:10.1136/bmj.a2278 CrossRef Gunnell D, Hawton K, Ho D, Evans J, O’Connor S, Potokar J, Donovan J, Kapur N (2008) Hospital admissions for self harm after discharge from psychiatric inpatient care: cohort study. BMJ 337:1331–1334. doi:10.​1136/​bmj.​a2278 CrossRef
47.
go back to reference Kendall T, Taylor C, Bhatti H, Chan M, Kapur N, Guideline Development Group of the National Institute for Health and Clinical Excellence (2011) Longer term management of self harm: summary of NICE guidance. BMJ 343:d7073CrossRefPubMed Kendall T, Taylor C, Bhatti H, Chan M, Kapur N, Guideline Development Group of the National Institute for Health and Clinical Excellence (2011) Longer term management of self harm: summary of NICE guidance. BMJ 343:d7073CrossRefPubMed
Metadata
Title
Young people who self-harm: a prospective 1-year follow-up study
Authors
Madiha Majid
Maria Tadros
George Tadros
Swaran Singh
Matthew R. Broome
Rachel Upthegrove
Publication date
01-02-2016
Publisher
Springer Berlin Heidelberg
Published in
Social Psychiatry and Psychiatric Epidemiology / Issue 2/2016
Print ISSN: 0933-7954
Electronic ISSN: 1433-9285
DOI
https://doi.org/10.1007/s00127-015-1149-4

Other articles of this Issue 2/2016

Social Psychiatry and Psychiatric Epidemiology 2/2016 Go to the issue