New research has found the risk of repeated self-harm is associated with certain sociodemographic characteristics.
The study found repeated self-harm was more likely to occur among younger emerging adult males, adolescent females, females using self-cutting, and individuals who previously self-harmed.
The study, published in the journal BMC Psychiatry, was based on data from 28,700 individuals in Ireland who were involved in 42,642 self-harm episodes. The research examined all methods of self-harm, such as intentional drug overdoses, alcohol overdoses or lacerations.
PsyPost interviewed the study’s corresponding author, Marco Bennardi of University College Cork. Read his responses below:
PsyPost: Why were you interested in this topic?
Bennardi: I have been interested in self-harm among young people since my first years at university, and my interest raised when I arrived in Ireland to work on a project focussed on youth mental health. When I arrived in Ireland and I started working at the project, I realised that there was a very valuable registry (Self-harm Registry Ireland) assessing every single emergency department (ED) presentation due to self-harm in the whole country. Additionally, I found out that no studies on self-harm repetition in young people with national coverage had been conducted yet. Therefore, I realised that there was a need to conduct a new study in order to identify risk factors for long-term repetition of self-harm among children, adolescents and young adults admitted to hospital emergency departments in Ireland.
What should the average person take away from your study?
First, our findings showed that pattern of self-harm repetition in young people differed according to age, gender and self-harm history. Particularly, we found that the subgroups of young people with the highest risk for repeated self-harm were 15-19-year-old females and 20-24-year-old males. Additionally, this study showed that time between first self-harm presentations represents an indicator of subsequent repetition. Finally, our findings revealed that some self-harm methods are associated with higher risk of self-harm repetition than other methods. Primarily self-cutting, both combined and not combined with intentional drug overdose was associated with the highest risk of self-harm repetition.
Are there any major caveats? What questions still need to be addressed?
In this study, we included all ED presentations due to self-harm occurred in an entire country for a long time period. The national coverage was one of the major strength of this study. However, within Ireland, as elsewhere, there are several differences between geographical areas. Additionally, previous research showed that geographical differences in self-harm presentations might be explained also by social fragmentation and deprivation. Therefore, in the future, it would be relevant to conduct a study similar to ours with the inclusion of a deprivation index.
Is there anything else you would like to add?
This study showed that a number of subgroups of young patients presenting to hospital due to self-harm are at elevated risk of repeating a self-harm act within one year. Although some subgroups are at higher risk to re-present, each person presenting at ED should receive a risk assessment to reduce the likelihood that such person re-presents over and over again with the same problem. Appropriate aftercare plan following a presentation due to self-harm should be put in place for everyone, irrespective of age or other characteristics.
The outcomes of this study highlight the importance of taking into account psychosocial characteristics, history of self-harm and the time between first presentations during risk assessment, as these represent indicators of risk of subsequent self-harm. This information might be useful for health care providers and, in general, for all those people dealing with young people who self-harm.
The study, “Risk of repeated self-harm and associated factors in children, adolescents and young adults“, was also co-authored by Elaine McMahon, Paul Corcoran, Eve Griffin and Ella Arensman.
