Suchergebnisse

Abstract. Background: Overall gender ratios are often quoted in studies of deliberate self-harm (DSH) patients, almost always with higher rates in females than males. Reporting a ratio across all ages may conceal important variations in the gender ratio across the life cycle. Method: Analysis was done of the gender ratio by age groups in rates of DSH in a consecutive sample of DSH patients presenting to a general hospital over a 10-year period. The patients were identified through a well-established monitoring system. Results: The study sample included 2,189 female and 1,439 male patients. While the overall gender rate ratio was 1.5 females to each male, the ratio varied considerably by age group: 8:1 in 10-14-year-olds, 3.1:1 in 15-19-year-olds, 1.6:1 in 20-24-year-olds, approximately 1.3:1 in 25-49-year-olds, and 0.8:1 in people aged 50 years and over. Conclusion: Statements about overall gender ratios for DSH conceal important changes in the ratio across the life cycle. These changes probably reflect differences in development and problems faced in adolescence, changes in motivation for DSH with age, and the closer resemblance of DSH to suicide in older age groups.

The aims of this study were to identify in what ways adolescents who cut themselves differ from those who take overdoses, and to investigate the role of contagion in these behaviours. Data from an anonymous self-report questionnaire survey of 6,020 adolescents in 41 schools were analysed. Comparison of 220 adolescents who reported self-cutting in the previous year with 86 who had taken overdoses in the previous year as the sole method of deliberate self-harm (DSH) showed that far more of those who cut themselves had friends who had also engaged in DSH in the same period (OR 2.84, 95% CI 1.5–5.3, P < 0.001), and fewer had sought help from friends before cutting (OR 0.5, 95% CI 0.3–0.9, P < 0.02). Self-cutting usually involved less premeditation. Analyses at both the individual and school level showed that the association between engaging in DSH and exposure to DSH amongst peers was largely confined to girls who cut themselves. There are important differences between adolescents who cut themselves and those who take overdoses. Contagion may be an important factor in DSH by adolescents, especially in girls who cut themselves. These findings are relevant to the design of prevention and treatment programmes.

Monitoring of deliberate self-harm (DSH) presentations to hospitals (and in other settings) is receiving increased attention in many countries. This is due to greater recognition of the size of the problem and awareness of its relevance to suicide prevention policy initiatives, because of the strong association between DSH and suicide. A system for monitoring all DSH presentations has been in place in the general hospital in Oxford for 30 years. Based on our experience, in this paper we describe procedures for monitoring, including case definition and identification, linkage of persons and episodes in order to investigate repetition of DSH and other outcomes (including deaths), and data protection and ethical issues. We also provide details of how to carry out monitoring, including different models of data collection, and what data to collect. Finally we consider the potential uses of the data for both clinical and research purposes, including evaluation of national suicide prevention initiatives.