National Suicide Research Foundation and.
J Ment Health. 2014 Jun;23(3):115-9. doi: 10.3109/09638237.2013.841867. Epub 2013 Dec 12.
Risk assessment forms a key component in self-harm management. Among self-harm presentations generally, lethality of an index act is a poor predictor of future non-fatal repetition. However, no study has examined whether severity of an index self-cutting episode is associated with prospective repetition.
To examine factors associated with severity of self-cutting and in particular the association between severity of self-cutting and prospective repetition of self-harm.
All index self-cutting presentations to emergency departments in Ireland over 5 years were grouped by treatment received and compared on the basis of demographic and clinical characteristics.
Receiving more extensive medical treatment was associated with male gender, being aged more than 15 years, and not combining self-harm methods. Receiving less extensive treatment conferred a higher risk of prospective 12-month repetition, even after controlling for demographic and clinical characteristics. Repeat self-harm presentations by those with more severe self-cutting in an index act were less prevalent but were more likely to involve high-lethality methods of self-harm.
The results indicate that the already-elevated repetition risk among self-cutting patients is further increased for those receiving less extensive wound closure treatment. Severity of self-cutting might also affect suicide risk but such an association has yet to be examined.
风险评估是自我伤害管理的一个关键组成部分。在一般的自我伤害表现中，指数行为的致命性是未来非致命性重复的一个糟糕预测指标。然而，尚无研究探讨指数自切割事件的严重程度是否与前瞻性重复有关。
检查与自切割严重程度相关的因素，特别是自切割严重程度与前瞻性自我伤害重复之间的关联。
将爱尔兰急诊部门 5 年来所有的指数自切割表现按所接受的治疗进行分组，并根据人口统计学和临床特征进行比较。
接受更广泛的医疗治疗与男性、年龄超过 15 岁以及不结合自伤方法有关。即使在控制了人口统计学和临床特征后，接受较少广泛治疗的患者，其在未来 12 个月内重复自我伤害的风险更高。在指数行为中自我切割更严重的患者再次自我伤害的情况较少见，但更可能涉及高致命性的自我伤害方法。
结果表明，对于接受较少广泛的伤口闭合治疗的患者，已经升高的重复风险进一步增加。自我切割的严重程度也可能影响自杀风险，但这种关联尚未得到检验。
