Violent self-harm may predict subsequent suicide

Dr Jessica Edwards

Jessica received her MA in Biological Sciences and her DPhil in Neurobehavioural Genetics from the University of Oxford (Magdalen College). After completing her post-doctoral research, she moved into scientific editing and publishing, first working for Spandidos Publications (London, UK) and then moving to Nature Publishing Group. Jessica is now a freelance editor and science writer, and started writing for “The Bridge” in December 2017.

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Researchers in Sweden have found that violent methods of self-harm requiring hospitalization may indicate high risk of future suicide in adolescents and young women. The researchers searched five, Swedish hospital registers and recorded information on events of non-fatal self-harm between years 2000 and 2009 in patients aged 10-24 years. They categorized methods of self-harm as: “poisoning”, “cutting or piercing”, “violent methods” (including gassing, hanging, strangulation, suffocation, drowning, firearm/explosives, and jumping from a height), “other” or “multiple”.

They identified >24,000 individuals (mean age 19.3 years, ~69% women) with >38,000 acts of non-fatal self-harm treated in specialist (non-psychiatric) health-care settings. A total of 306 suicides were identified during follow-up, the majority of which occurred in patients aged 18-24 years. Cutting and poisoning were the most prevalent methods of self-harm that required inpatient care.

However, among 10-17 year olds, a violent method of self-harm registered in inpatient care was associated with ~8-fold elevated risk of suicide compared to self-poisoning methods. In women aged 18-24 years, both violent methods of self-harm and cutting were associated with ~4-fold increased risk of suicide compared to poisoning. The researchers conclude that adolescents requiring inpatient care due to violent methods of self-harm, or young women using either violent methods or cutting, may be at a particularly high risk of future suicide attempts.

Beckman, K., Mittendorfer-Rutz, E., Waern, M., Larsson, H., Runeson, B. & Dahlin, M. (2018), Method of self-harm in adolescents and young adults and risk of subsequent suicide. J Child Psychol Psychiatr. doi:10.1111/jcpp.12883

Read the Self-harm and Suicide Editorial of The Bridge by Dr Juliette Kennedy

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