Keith Hawton1, Louise Harriss. 1. Centre for Suicide Research, University of Oxford Department of Psychiatry, Warneford Hospital, Headington, Oxford OX3 7JX, UK. keith.hawton@psych.ox.ac.uk
Abstract
BACKGROUND: Little information is available about older deliberate self-harm (DSH) patients and their outcome. METHODS: This study is a prospective investigation and follow-up of 730 consecutive patients (459 females and 271 males) aged 60 years and over who presented to a general hospital following DSH over a 20-year period, 1978-1997. Outcome has been examined in terms of repetition of DSH, and deaths by the end of 2000 identified through official death registers. RESULTS: DSH involved self-poisoning in 88.6% of cases, 49.3% of the overdoses including paracetamol (acetaminophen), 24.0% minor tranquillizers, and 15.9% antidepressants. Nearly three-quarters of episodes involved high suicidal intent. Common problems preceding DSH were physical illness (46.1%), social isolation (33.5%), relationship problems with family (29.4%) or partner (25.9%), and bereavement or loss (16.7%). Repetition of DSH occurred in 15.3% of cases, 8.2% in the first year following DSH. By the end of 2000, 432/661 (65.4%) of traced patients had died. There were 30 suicides and open verdicts, which were 49 times and 33 times more frequent respectively than expected from general population death rates. Prior DSH before initial presentation was the main risk factor for suicide, with some evidence of high suicide intent being another factor. There were also excess deaths due to several types of physical disorder. CONCLUSIONS: DSH in older people is closely related to suicide, both in terms of suicidal intent and risk of eventual suicide, especially when DSH is repeated. The range of problems experienced by older DSH patients requires extensive and multidisciplinary clinical interventions.
BACKGROUND: Little information is available about older deliberate self-harm (DSH) patients and their outcome. METHODS: This study is a prospective investigation and follow-up of 730 consecutive patients (459 females and 271 males) aged 60 years and over who presented to a general hospital following DSH over a 20-year period, 1978-1997. Outcome has been examined in terms of repetition of DSH, and deaths by the end of 2000 identified through official death registers. RESULTS: DSH involved self-poisoning in 88.6% of cases, 49.3% of the overdoses including paracetamol (acetaminophen), 24.0% minor tranquillizers, and 15.9% antidepressants. Nearly three-quarters of episodes involved high suicidal intent. Common problems preceding DSH were physical illness (46.1%), social isolation (33.5%), relationship problems with family (29.4%) or partner (25.9%), and bereavement or loss (16.7%). Repetition of DSH occurred in 15.3% of cases, 8.2% in the first year following DSH. By the end of 2000, 432/661 (65.4%) of traced patients had died. There were 30 suicides and open verdicts, which were 49 times and 33 times more frequent respectively than expected from general population death rates. Prior DSH before initial presentation was the main risk factor for suicide, with some evidence of high suicide intent being another factor. There were also excess deaths due to several types of physical disorder. CONCLUSIONS: DSH in older people is closely related to suicide, both in terms of suicidal intent and risk of eventual suicide, especially when DSH is repeated. The range of problems experienced by older DSH patients requires extensive and multidisciplinary clinical interventions.
Authors: Barbara Stanley; Leo Sher; Scott Wilson; Rolf Ekman; Yung-yu Huang; J John Mann Journal: J Affect Disord Date: 2009-11-25 Impact factor: 4.839
Authors: Matthew Miller; Katherine Hempstead; Tuan Nguyen; Catherine Barber; Sarah Rosenberg-Wohl; Deborah Azrael Journal: Am J Public Health Date: 2013-04-18 Impact factor: 9.308