Black Dog Institute, University of New South Wales, Randwick, NSW 2031, Australia.
School of Psychology, Western Sydney University, Penrith, NSW 2751, Australia.
J Affect Disord. 2023 Jan 15;321:191-200. doi: 10.1016/j.jad.2022.10.032. Epub 2022 Oct 21.
Self-harm is a critical issue affecting young people which could result in adverse outcomes including repeat episodes and suicide. In this study, we aimed to estimate the short-term and long-term risk of repeat self-harm and subsequent suicide death following self-harm presentations among adolescents and young adults.
Using linked data from the New South Wales (NSW) Emergency Department Data Collection (EDDC), the NSW Admitted Patient Data Collection (APDC), and cause of death unit record file (COD-URF), we collected all self-harm presentations to emergency departments and/or hospitals and suicide deaths between 2012 and 2019 in NSW, Australia. We used survival analysis models to estimate the incidence of repeat self-harm and suicide by time since the index self-harm and relative risks by sex, type of hospital presentation and count of self-harm records.
In total, we identified 81,133 self-harm episodes among 48,547 individuals aged 10-29 years. Of 48,547 individuals who engaged in an index self-harm during the study period, 39.5 % (19,180) were aged between 15 and 19 years. The incidence of both repeat self-harm and suicide were highest in the year following the index self-harm presentation (repeat self-harm: 188.84 per 1000 person-years; suicide: 3.30 per 1000 person-years) and declined to 14.51 and 0.28 per 1000 person-years after five years. Among individuals indexed for self-harm at 15-29 years, males and those who were admitted to hospital for the index self-harm had the highest risk of both subsequent repeat self-harm and suicide death and those with 2 or more self-harm presentation records had the higher risk for subsequent suicide death.
Adolescents and young adults with self-harm presentations were at a high risk of subsequent repeat self-harm and suicide death, especially the first year after presentations. Youth-specific early intervention and long-term management should be delivered accordingly, especially for those at early adolescence .
自残是影响年轻人的一个严重问题，可能导致不良后果，包括再次发作和自杀。在这项研究中，我们旨在估计青少年和年轻人自残就诊后短期内和长期内再次自残和随后自杀死亡的风险。
利用来自新南威尔士州（NSW）急诊部数据采集（EDDC）、新南威尔士州住院病人数据采集（APDC）和死因单位记录文件（COD-URF）的关联数据，我们收集了 2012 年至 2019 年期间新南威尔士州所有急诊部门和/或医院的自残就诊和自杀死亡情况。我们使用生存分析模型来估计自指数自残以来再次自残和自杀的发生率，并按性别、医院就诊类型和自残记录次数来估计相对风险。
我们总共确定了 81133 例 48547 名 10-29 岁个体的自残事件。在研究期间发生指数自残的 48547 名个体中，39.5%（19180 人）年龄在 15-19 岁之间。自残就诊后一年再次自残和自杀的发生率最高（再次自残：188.84/1000人年；自杀：3.30/1000人年），五年后降至 14.51/1000人年和 0.28/1000人年。在 15-29 岁索引自残的个体中，男性和因索引自残而住院的个体随后再次自残和自杀死亡的风险最高，而有 2 次或更多自残就诊记录的个体随后自杀死亡的风险更高。
自残就诊的青少年和年轻人随后再次自残和自杀死亡的风险很高，尤其是就诊后第一年。应相应地提供针对青年的早期干预和长期管理，特别是针对青春期早期的青年。
