Epidemiology and nature of self-harm in children and adolescents: findings from the multicentre study of self-harm in England

Abstract

We examined epidemiology and characteristics of self-harm in adolescents and impact of national guidance on management. Data were collected in six hospitals in three centres between 2000 and 2007 in the Multicentre Study of Self-harm in England. Of 5,205 individuals (7,150 episodes of self-harm), three-quarters were female. The female:male ratio in 10-14 year-olds was 5.0 and 2.7 in 15-18 year-olds. Rates of self-harm varied somewhat between the centres. In females they averaged 302 per 100,000 (95 % CI 269-335) in 10-14 year-olds and 1,423 (95 % CI 1,346-1,501) in 15-18 year-olds, and were 67 (95 % CI 52-82) and 466 (95 % CI 422-510), respectively, in males. Self-poisoning was the most common method, involving paracetamol in 58.2 % of episodes. Presentations, especially those involving alcohol, peaked at night. Repetition of self-harm was frequent (53.3 % had a history of prior self-harm and 17.7 % repeated within a year). Relationship problems were the predominant difficulties associated with self-harm. Specialist assessment occurred in 57 % of episodes. Self-harm in children and adolescents in England is common, especially in older adolescents, and paracetamol overdose is the predominant method. National guidance on provision of psychosocial assessment in all cases of self-harm requires further implementation.

Incidence, clinical management, and mortality risk following self harm among children and adolescents: cohort study in primary care

“…Having stratified on age band, index of multiple deprivation, and region of residence, we then applied stratum specific rates to calculate directly standardised incidence rates. Age was categorised as pre-teenager (10)(11)(12), early teenager (13)(14)(15)(16), and late teenager (17)(18)(19) year bands, and the index of multiple deprivation was placed into fifths based on general practice location.…”

“…This is consistent with previous hospital based studies 1324 and a recent primary care based study reporting on self poisoning. 25 Lower annual incidence rates were reported from a study based in six hospitals, 30.2 (95% confidence interval 26.9 to 33.5) per 10 000 for girls aged 10-14 years and 6.7 (5.2 to 8.2) per 10 000 for boys, 13 although caution is required when comparing rates across studies, as differences in self harm definitions, derivation of rates, age ranges and age categorisations, and timescale used must be carefully considered.…”

Self-harm in young people

“…Here, ‘young people’ refers to anyone from age 11 up to the age of 25 years, since psychologists and neuroscientists now suggest this as the most appropriate cut-off for late-adolescence. Hospital-based data demonstrate that self-harm is most common in 15–24-year-olds, with females presenting more frequently than males 2. However, hospital-based statistics are likely to be the ‘tip of the iceberg’, with many more episodes occurring in the community that do not come to medical attention; community-based studies estimate that around 10% of young people have self-harmed 3…”

Assessment of Suicidal Poisoning In Our Pediatric Emergency Department

“…Kızlarda erkeklere göre özkıyım girişimi daha fazla olmasına karşın erkeklerde tamamlanmış özkıyım daha fazla görülmektedir (4)(5)(6). Özkıyım asılma, delici-kesici alet dışında en sık zehirlenme sonucu ortaya çıkar (5)(6)(7)(8). Ülkemizde özkıyım olgularının %94.3-%94.8' inin ilaçlarla, geri kalanların ise ilaç içme ile birlikte kesici-delici alet kullanımı ile gerçekleştirildiği bildirilmiştir (6,8).…”

“…Çalışmamızda zehirlenme ile başvuran özkıyım olguları değerlendirilmeye çalışılmıştır. (4)(5)(6)(7)(8)(9)(10). Bizim çalışmamızda da bir fare zehiri alan olgu hariç hepsi ilaç ile girişimde bulunmuştu.…”