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