Predictors for repeat self-harm and suicide among older people within 12 months of a self-harm presentation.

Abstract:

BACKGROUND:A past history of self-harm is a significant risk factor for suicide in older people. The aims of this study are to (i) characterize older people who present with self-harm to emergency departments (EDs); and (ii) determine the predictors for repeat self-harm and suicide. METHODS:Demographic and clinical data were retrospectively collected on older people (age 65+ years), who presented to seven EDs in New Zealand following an episode of self-harm between 1st July 2010 and 30th June 2013. In addition, 12-month follow-up information on repeat self-harm and suicide was collected. RESULTS:The sample included 339 older people (55.2% female) with an age range of 65-96 years (mean age = 75.0; SD = 7.6). Overdose (68.7%) was the most common method of self-harm. 76.4% of the self-harm cases were classified as suicide attempts. Perceived physical illness (47.8%) and family discord (34.5%) were the most common stressors. 12.7% of older people repeated self-harm and 2.1% died by suicide within 12 months. Older people who had a positive blood alcohol reading (OR = 3.87, 95% Cl = 1.35-11.12, p = 0.012) and were already with mental health services at the index self-harm (OR = 2.73, 95% Cl = 1.20-6.25, p = 0.047) were more likely to repeat self-harm/suicide within 12 months. CONCLUSION:Older people who self-harm are at very high risk of repeat self-harm and suicide. Screening and assessment for alcohol use disorders should be routinely performed following a self-harm presentation, along with providing structured psychological treatment as an adjunct to pharmacological treatment for depression and interventions to improve the person's resilience resources.

journal_name

Int Psychogeriatr

authors

Cheung G,Foster G,de Beer W,Gee S,Hawkes T,Rimkeit S,Tan YM,Merry S,Sundram F

doi

10.1017/S1041610217000308

subject

Has Abstract

pub_date

2017-08-01 00:00:00

pages

1237-1245

issue

8

eissn

1041-6102

issn

1741-203X

pii

S1041610217000308

journal_volume

29

pub_type

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