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First Episode of Self-Harm in Older Age
- Source :
- Journal of Clinical Psychiatry, 72, 6, pp. 737-43, Journal of Clinical Psychiatry, 72(6), 737-743. Physicians Postgraduate Press Inc., Journal of Clinical Psychiatry, 72, 737-43
- Publication Year :
- 2011
-
Abstract
- Objective: Self-harm is closely related to completed suicide, especially in older age. As empirical research of self-harm in older age is scarce, with no studies confined to first-ever episodes in older age, we examined the clinical characteristics and the risk of repetition in first-ever self-harm in older age.Method: The Manchester Self-Harm (MaSH) project, a prospective cohort study, gathered data from September 1, 1997, through August 31, 2007, for individuals presenting with self-harm at emergency departments of 3 large hospitals in North West England. The characteristics of older patients (aged 55 years) who presented with a first-ever episode of self-harm are described and compared to those of middle-aged patients (35-54 years) presenting with a first-ever episode of self-harm. Following each episode, the MaSH form, a standard assessment form developed for the MaSH project, was completed by a clinician. Potential risk factors for repetition were examined by Cox regression analyses.Results: A total of 374 older patients and 1,937 middle-aged patients presented with a first-ever episode of self-harm. The circumstances at the time of self-harm suggested higher suicidal intent in older age. In comparison with middle-aged patients, the rate of repetition in older-aged patients was lower (15.4% versus 11.8%, respectively; hazard ratio for older age = 0.65; 95% CI, 0.45-0.93; P=.019), although repetition was more often fatal among the older group (3.3% versus 13.6%, respectively; P=.009). The most important predictor of repetition in older age, ie, physical health problems, had no predictive value in middle-aged patients, whereas psychiatric characteristics had little impact on the risk of repetition in old age.Conclusions: High suicidal intent and different predictors of repetition in first-ever self-harm in older age highlight the need for age-specific interventions beyond the scope of psychiatric care alone. J Clin Psychiatry 2011;72(6):737-743 (C) Copyright 2011 Physicians Postgraduate Press, Inc.
- Subjects :
- Adult
Male
medicine.medical_specialty
LIFE EVENTS
PARASUICIDE
Poison control
Suicide, Attempted
Suicide prevention
Mental health [NCEBP 9]
Statistics, Nonparametric
Recurrence
Risk Factors
Injury prevention
Humans
Medicine
REPETITION
COHORT
Prospective Studies
Age of Onset
Prospective cohort study
Psychiatry
TERM-FOLLOW-UP
Aged
Proportional Hazards Models
ASSOCIATIONS
Aged, 80 and over
First episode
SUICIDAL-BEHAVIOR
Chi-Square Distribution
business.industry
Hazard ratio
Age Factors
Middle Aged
TIME
Hospitalization
Psychiatry and Mental health
England
SUBSEQUENT SUICIDE
Cohort
Female
Parasuicide
Emergency Service, Hospital
business
Self-Injurious Behavior
INTENT
Subjects
Details
- Language :
- English
- ISSN :
- 01606689
- Volume :
- 72
- Issue :
- 6
- Database :
- OpenAIRE
- Journal :
- Journal of Clinical Psychiatry
- Accession number :
- edsair.doi.dedup.....4b2f7de0eb83c9bafb024e64dfe8ce6a