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The risk of repeated self-harm and suicide after emergency department presentation with self-harm in mental health presenters: a retrospective cohort study with data linkage in Queensland, Australia

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Τίτλος: The risk of repeated self-harm and suicide after emergency department presentation with self-harm in mental health presenters: a retrospective cohort study with data linkage in Queensland, Australia
Συγγραφείς: Pellatt, RAF, Painter, DR, Young, JT, Kõlves, K, Keijzers, G, Kinner, SA, Heffernan, E, Crilly, J
Στοιχεία εκδότη: Elsevier BV
Έτος έκδοσης: 2025
Συλλογή: The University of Melbourne: Digital Repository
Περιγραφή: BACKGROUND: Presentation to the emergency department (ED) with an index episode of self-harm is recognised as a risk factor for subsequent repeated self-harm and suicide. We describe demographic and clinical characteristics of adults (>18 years) presenting with mental health problems and self-harm to EDs in Queensland, Australia, and identify risk factors associated with repeated self-harm and suicide. METHODS: This was a state-wide retrospective cohort study of adults presenting with an index self-harm presentation to any of the 27 public EDs in Queensland, Australia, over six years (1st January 2012 to 31st December 2017). We linked ED records with a state-wide death register. Primary outcomes were re-presentation with self-harm, or death by suicide. We constructed a multivariable Cox regression model to identify independent risk factors for re-presentation with self-harm, or death by suicide. We calculated the risk of repeated ED presentation for self-harm and suicide at 12- and 24-months. FINDINGS: During the study period, 43,797 individuals presented to Queensland EDs with a self-harm related diagnosis. Half of the cohort were female (n = 20,980, 47.9%) and under age 35 (n = 23,871, 54.5%). A quarter (n = 10,991; 25.1%) had a repeated episode of self-harm and 515 (1.2%) died by suicide. Socioeconomic disadvantage, arrival by ambulance, self-presentation, small/medium hospital size, less-urgent triage category, not admitted status and previous mental health or physical health visits were associated with a re-presentation with self-harm. Suicide was associated with male sex, older age, and hospital admission. The repeated self-harm risk was 18.9% (95%CI, 18.5%-19.3%) at 12-months and 24.3% (95%CI, 23.9%-24.7%) at 24-months. The suicide risk was 0.7% (95%CI, 0.6%-0.7%) at 12-months and 1.0% (95%CI, 0.9%-1.1%) at 24-months. INTERPRETATION: One in four people re-presented to ED with self-harm. Suicide was particularly associated with older males. Implementing evidence-based interventions to support people ...
Τύπος εγγράφου: article in journal/newspaper
Γλώσσα: English
ISSN: 2666-6065
Relation: https://hdl.handle.net/11343/359730
Διαθεσιμότητα: https://hdl.handle.net/11343/359730
Rights: https://creativecommons.org/licenses/by-nc-nd/4.0 ; CC BY-NC-ND
Αριθμός Καταχώρησης: edsbas.3EB65150
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  Data: The risk of repeated self-harm and suicide after emergency department presentation with self-harm in mental health presenters: a retrospective cohort study with data linkage in Queensland, Australia
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  Data: BACKGROUND: Presentation to the emergency department (ED) with an index episode of self-harm is recognised as a risk factor for subsequent repeated self-harm and suicide. We describe demographic and clinical characteristics of adults (>18 years) presenting with mental health problems and self-harm to EDs in Queensland, Australia, and identify risk factors associated with repeated self-harm and suicide. METHODS: This was a state-wide retrospective cohort study of adults presenting with an index self-harm presentation to any of the 27 public EDs in Queensland, Australia, over six years (1st January 2012 to 31st December 2017). We linked ED records with a state-wide death register. Primary outcomes were re-presentation with self-harm, or death by suicide. We constructed a multivariable Cox regression model to identify independent risk factors for re-presentation with self-harm, or death by suicide. We calculated the risk of repeated ED presentation for self-harm and suicide at 12- and 24-months. FINDINGS: During the study period, 43,797 individuals presented to Queensland EDs with a self-harm related diagnosis. Half of the cohort were female (n = 20,980, 47.9%) and under age 35 (n = 23,871, 54.5%). A quarter (n = 10,991; 25.1%) had a repeated episode of self-harm and 515 (1.2%) died by suicide. Socioeconomic disadvantage, arrival by ambulance, self-presentation, small/medium hospital size, less-urgent triage category, not admitted status and previous mental health or physical health visits were associated with a re-presentation with self-harm. Suicide was associated with male sex, older age, and hospital admission. The repeated self-harm risk was 18.9% (95%CI, 18.5%-19.3%) at 12-months and 24.3% (95%CI, 23.9%-24.7%) at 24-months. The suicide risk was 0.7% (95%CI, 0.6%-0.7%) at 12-months and 1.0% (95%CI, 0.9%-1.1%) at 24-months. INTERPRETATION: One in four people re-presented to ED with self-harm. Suicide was particularly associated with older males. Implementing evidence-based interventions to support people ...
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