Patterns of self-harm methods over time and the association with methods used at repeat episodes of non-fatal self-harm and suicide: A systematic review.


Journal

Journal of affective disorders
ISSN: 1573-2517
Titre abrégé: J Affect Disord
Pays: Netherlands
ID NLM: 7906073

Informations de publication

Date de publication:
15 02 2019
Historique:
received: 16 07 2018
revised: 12 09 2018
accepted: 01 11 2018
pubmed: 12 11 2018
medline: 10 4 2019
entrez: 12 11 2018
Statut: ppublish

Résumé

The risk of self-harm repetition and suicide may be influenced by self-harm method choice. However, there are mixed findings regarding whether there is a discernible pattern in self-harm methods over successive episodes of non-fatal self-harm, and if so, how these may be associated with self-harm repetition and/or suicide. A systematic review of five electronic databases was undertaken until 31 May 2018 to identify cohort studies on patterns of self-harm methods and their association with methods used either at repeat self-harm episodes and/or suicide. 15 studies were included reporting data on of 127,371 participants. Over an average follow-up period of 2.8 years, one-third (33.3%) switched methods between episodes of self-harm, most commonly from self-injury to self-poisoning. For suicide, almost one-half (42.1%) switched methods over an average follow-up period of 11.2 years. Studies were characterised by a moderate study quality. Studies tended to group all methods into self-injury and/or self-poisoning with little consideration as to the diverse range of self-harm methods included within these broad categories and the likely differences in potential lethality between these methods. Few investigated the role of alcohol and/or drug dependence and mental illness on self-harm method choice. Given the frequency of method switching observed, and the lack of discernible patterns over time, all patients should be routinely assessed for risk and needs irrespective of the method used at the index episode of non-fatal self-harm.

Sections du résumé

BACKGROUND
The risk of self-harm repetition and suicide may be influenced by self-harm method choice. However, there are mixed findings regarding whether there is a discernible pattern in self-harm methods over successive episodes of non-fatal self-harm, and if so, how these may be associated with self-harm repetition and/or suicide.
METHODS
A systematic review of five electronic databases was undertaken until 31 May 2018 to identify cohort studies on patterns of self-harm methods and their association with methods used either at repeat self-harm episodes and/or suicide.
RESULTS
15 studies were included reporting data on of 127,371 participants. Over an average follow-up period of 2.8 years, one-third (33.3%) switched methods between episodes of self-harm, most commonly from self-injury to self-poisoning. For suicide, almost one-half (42.1%) switched methods over an average follow-up period of 11.2 years.
LIMITATIONS
Studies were characterised by a moderate study quality. Studies tended to group all methods into self-injury and/or self-poisoning with little consideration as to the diverse range of self-harm methods included within these broad categories and the likely differences in potential lethality between these methods. Few investigated the role of alcohol and/or drug dependence and mental illness on self-harm method choice.
CONCLUSIONS
Given the frequency of method switching observed, and the lack of discernible patterns over time, all patients should be routinely assessed for risk and needs irrespective of the method used at the index episode of non-fatal self-harm.

Identifiants

pubmed: 30415124
pii: S0165-0327(18)31531-3
doi: 10.1016/j.jad.2018.11.001
pii:
doi:

Types de publication

Journal Article Research Support, Non-U.S. Gov't Systematic Review

Langues

eng

Sous-ensembles de citation

IM

Pagination

250-264

Informations de copyright

Copyright © 2018. Published by Elsevier B.V.

Auteurs

Katrina Witt (K)

Turning Point, Eastern Health and Eastern Health Clinical School, Monash University, Australia. Electronic address: katrina.witt@monash.edu.

Caroline Daly (C)

National Suicide Research Foundation, School of Public Health, University College Cork, Ireland.

Ella Arensman (E)

National Suicide Research Foundation, School of Public Health, University College Cork, Ireland.

Jane Pirkis (J)

Centre for Mental Health, School of Population and Global Health, The University of Melbourne, Australia.

Dan Lubman (D)

Turning Point, Eastern Health and Eastern Health Clinical School, Monash University, Australia.

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