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Title: Intoxication with alcohol at the time of self-harm and pre-existing involvement with mental health services are associated with a pre-disposition to repetition of self-harming behavior in a large cohort of older New Zealanders presenting with an index episode of self-harm.
Epworth Authors: Ames, David
Keywords: Self-Harm
Repeat Self-Harm
Late Life
Mental Health Services
Emergency Departments
Rehabilitation, Mental Health and Chronic Pain Clinical Institute, Epworth HealthCare, Victoria, Australia
Issue Date: Aug-2017
Publisher: Cambridge University Press
Citation: Int Psychogeriatr. 2017 Aug;29(8):1235
Abstract: The paper on predictors of repeat self-harm and suicide by Cheung et al. (2017), which has been chosen by the editorial team as paper of the month for this issue of International Psychogeriatrics, makes a very useful contribution to the study of self-harm and suicide in late life. Of 339 individuals presenting with an index episode of self-harm to one of seven Emergency Departments (EDs) in New Zealand, close to 15% harmed themselves again within one year and for nearly one in six of these 50 people, the repeat episode was fatal. Having alcohol in the blood and already being engaged with mental health services at the time of the index episode both had some utility in predicting the occurrence of a further self-harm episode. While it is encouraging that mental health services look to have been focusing on those who turned out to be at highest risk, clinicians may need to be particularly vigilant when following up individuals who had been drinking alcohol at the time of an initial self-harm presentation. This study also emphasizes the high risk of recurrent self-harm and completed suicide in those older adults who harm themselves and survive the initial episode. It deserves to be widely cited and gives some direction for future research on interventions designed to diminish the recurrence of self-harm in those of our patients who have presented to an ED with an initial self-harm episode.
DOI: 10.1017/S104161021700093X
PubMed URL:
ISSN: 1041-6102
Journal Title: International Psychogeriatrics
Type: Journal Article
Affiliated Organisations: University of Melbourne Department of Psychiatry and National Ageing Research Institute
International Psychogeriatrics,Normanby House, St George's Hospital, Kew, Victoria, Australia
Type of Clinical Study or Trial: Prospective Cohort Study
Appears in Collections:Mental Health

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