The significance of site of cut in self-harm in young people.
Self-harm
Self-injury
Journal
Journal of affective disorders
ISSN: 1573-2517
Titre abrégé: J Affect Disord
Pays: Netherlands
ID NLM: 7906073
Informations de publication
Date de publication:
01 04 2020
01 04 2020
Historique:
received:
09
08
2019
revised:
17
11
2019
accepted:
20
01
2020
pubmed:
15
2
2020
medline:
16
2
2021
entrez:
15
2
2020
Statut:
ppublish
Résumé
Self-cutting in young people is associated with high risk of repetition and suicide. It is important, therefore, to identify characteristics of self-cutting that might impact on repetition and aspects of care by staff. This study aimed to explore differences in clinical (e.g., previous self-harm) and psychological characteristics (intent, mental state, precipitants) of self-cutting in young people based on whether site of cut was visible or concealed. Data were from a large prospective self-harm monitoring database that collected data on hospital emergency department presentations for self-harm in the City of Manchester, UK, between 2005 and 2011. Clinical and psychological characteristics, as well as onward referral/clinical management from the emergency department, of 799 young people (totalling 1,196 episodes) age 15-24 who self-cut in visible or concealed areas were compared using logistic regression. During the study period 500 (40%) episodes were in a concealed location. Concealed self-cutting was more likely to be precipitated by specific self-reported precipitants such as abuse and characterised by the following: previous self-harm, current psychiatric treatment, premeditation, and greater risk of repetition within the study period. Receiving a psychosocial assessment and referral to psychiatric services from the emergency department were less likely, however. Repetition and referral to psychiatric treatment were not significantly associated with site of injury when adjusting for other factors. There are meaningful differences in characteristics associated with location of cut. We recommend that all young people who present to hospital following self-harm receive a psychosocial assessment, in line with NICE guidance.
Sections du résumé
BACKGROUND
Self-cutting in young people is associated with high risk of repetition and suicide. It is important, therefore, to identify characteristics of self-cutting that might impact on repetition and aspects of care by staff. This study aimed to explore differences in clinical (e.g., previous self-harm) and psychological characteristics (intent, mental state, precipitants) of self-cutting in young people based on whether site of cut was visible or concealed.
METHODS
Data were from a large prospective self-harm monitoring database that collected data on hospital emergency department presentations for self-harm in the City of Manchester, UK, between 2005 and 2011. Clinical and psychological characteristics, as well as onward referral/clinical management from the emergency department, of 799 young people (totalling 1,196 episodes) age 15-24 who self-cut in visible or concealed areas were compared using logistic regression.
RESULTS
During the study period 500 (40%) episodes were in a concealed location. Concealed self-cutting was more likely to be precipitated by specific self-reported precipitants such as abuse and characterised by the following: previous self-harm, current psychiatric treatment, premeditation, and greater risk of repetition within the study period. Receiving a psychosocial assessment and referral to psychiatric services from the emergency department were less likely, however. Repetition and referral to psychiatric treatment were not significantly associated with site of injury when adjusting for other factors.
CONCLUSIONS
There are meaningful differences in characteristics associated with location of cut. We recommend that all young people who present to hospital following self-harm receive a psychosocial assessment, in line with NICE guidance.
Identifiants
pubmed: 32056933
pii: S0165-0327(19)32018-X
doi: 10.1016/j.jad.2020.01.093
pii:
doi:
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
603-609Subventions
Organisme : Department of Health
Pays : United Kingdom
Informations de copyright
Copyright © 2020. Published by Elsevier B.V.
Déclaration de conflit d'intérêts
Declaration of Competing Interest N.K. is a member of the U.K. Department of Health's National Suicide Prevention Advisory Group, and chaired the NICE guideline development group for the longer-term management of self-harm and the NICE Topic Expert Group which developed the quality standards for self-harm services. N.K. also chairs the NICE guideline committee for the management of depression. All other authors declare no conflict of interest.