Hu Nan, Glauert Rebecca A, Li Jianghong, Taylor Catherine L
Telethon Kids Institute, The University of Western Australia, Perth, WA, Australia The School of Population Health, The University of Western Australia, Perth, WA, Australia
Telethon Kids Institute, The University of Western Australia, Perth, WA, Australia.
Aust N Z J Psychiatry. 2016 Feb;50(2):154-66. doi: 10.1177/0004867415621391. Epub 2016 Jan 12.
The risk of repetition of deliberate self-harm peaks in the first 7 days after a deliberate self-harm episode. However, thus far no studies have examined the risk factors for repeating deliberate self-harm during this short-term period. We aimed to investigate the effects of socio-demographic factors, self-harm method and mental health factors in adolescents (10-19 years old) and young adults (20-29 years old).
We used data linkage of population-wide administrative records from hospital inpatients and emergency departments to identify all the deliberate self-harm-related episodes that occurred in adolescents and young adults in Western Australia from 2000 to 2011. Logistic regression with generalised estimating equations was used for the analyses.
The incidence of repeating deliberate self-harm within the first 7 days after an index episode was 6% (403/6,768) in adolescents and 8% (842/10,198) in young adults. Socio-demographic risk factors included female gender and socioeconomic disadvantage. Compared with non-poisoning, self-poisoning predicted increased risk of having a repeated deliberate self-harm episode in males, but not in females. Borderline personality, impulse-control and substance use disorders diagnosed within one week before and one week after an index deliberate self-harm episode conferred the highest risk, followed by depressive and anxiety disorders. Having a preceding deliberate self-harm episode up to 7 days before an index episode was a strong predictor for the future repetition of a deliberate self-harm episode.
Having a repeated deliberate self-harm episode within the first 7 days was related to a wide range of factors present at an index deliberate self-harm episode including socio-demographic characteristics, deliberate self-harm method and co-existing psychiatric conditions. These factors can inform risk assessments tailored to adolescents and young adults respectively to reduce the repetition of deliberate self-harm within a short but critical period, potentially contributing to reduce the repetition of deliberate self-harm in the long term.
蓄意自我伤害事件发生后的前7天内，重复蓄意自我伤害的风险达到峰值。然而，迄今为止尚无研究探讨这一短期期间内重复蓄意自我伤害的风险因素。我们旨在调查社会人口学因素、自我伤害方式和心理健康因素对青少年（10至19岁）和青年（20至29岁）的影响。
我们利用全人群范围内医院住院患者和急诊科行政记录的数据链接，识别2000年至2011年在西澳大利亚州青少年和青年中发生的所有蓄意自我伤害相关事件。采用广义估计方程的逻辑回归进行分析。
在索引事件后的前7天内，青少年重复蓄意自我伤害的发生率为6%（403/6768），青年为8%（842/10198）。社会人口学风险因素包括女性性别和社会经济劣势。与非中毒相比，自我中毒预示男性重复蓄意自我伤害事件的风险增加，但女性并非如此。在索引蓄意自我伤害事件前一周和后一周内诊断出的边缘性人格、冲动控制和物质使用障碍风险最高，其次是抑郁和焦虑障碍。在索引事件前长达7天有过蓄意自我伤害事件是未来重复蓄意自我伤害事件的有力预测因素。
在第1个7天内发生重复蓄意自我伤害事件与索引蓄意自我伤害事件时存在的多种因素有关，包括社会人口学特征、蓄意自我伤害方式和并存的精神疾病状况。这些因素可为分别针对青少年和青年的风险评估提供参考，以减少在短但关键的时期内重复蓄意自我伤害，有可能在长期内有助于减少蓄意自我伤害的重复发生。
