Centre for Self-Harm and Suicide Prevention Research, Research and Development Centre, Derbyshire Healthcare NHS Foundation Trust, Kingsway Hospital, Derby, UK.
Self-Harm Research Group, School of Psychology, University of Nottingham, University Park Nottingham, Nottingham, UK.
Int J Geriatr Psychiatry. 2023 Mar;38(3):e5895. doi: 10.1002/gps.5895.
Older adults have a high risk of suicide following self-harm. Contemporary information on self-harm in this population is needed to inform care provision.
To examine subgroup differences in the incidence of self-harm, sociodemographic and clinical characteristics, preceding life problems and outcomes in individuals aged 60 years and over presenting to hospital following self-harm.
Data on Emergency Department (ED) presentations for self-harm from 2003 to 2016 from three centres in the Multicentre Study of Self-Harm in England were analysed. Changes in self-harm rates were examined using Poisson regression. Univariable logistic regression was used to investigate factors associated with 12-month self-harm repetition.
There were 3850 presentations for self-harm by 2684 individuals aged 60 years and over. Self-harm rates increased over time for 60-74-year-old men (Incident Rate Ratio = 1.04, 95% Confidence Interval 1.02-1.06, p < 0.0001). Problems most frequently reported to have preceded self-harm were mental health (40.5%) and physical health (38.3%) concerns. Problems with alcohol, finances, employment and relationship with partner were found more frequently in 60-74-year-olds compared with those aged over 74 years. Physical health problems were common with increasing age, as were problems with alcohol for men. One in ten (10.8%) individuals presented to hospital with self-harm within 12 months of their index presentation.
Self-harm-related ED attendances in older men have increased, particularly for men aged 60-74 years. Prevention and clinical management should involve a comprehensive psychosocial assessment to target common precipitants for the wide range of problems preceding self-harm and may include support with physical and mental wellbeing and advice on safer alcohol use.
老年人在自我伤害后自杀的风险很高。为了提供护理，需要了解该人群中自我伤害的当代信息。
检查 60 岁及以上人群在自我伤害后到医院就诊时，自我伤害的发生率、社会人口学和临床特征、先前生活问题以及结局的亚组差异。
对来自英格兰多中心自我伤害研究的三个中心 2003 年至 2016 年急诊科就诊的自我伤害数据进行了分析。使用泊松回归检查自我伤害率的变化。使用单变量逻辑回归调查与 12 个月内自我伤害复发相关的因素。
共有 3850 名 2684 名 60 岁及以上的人因自我伤害就诊。60-74 岁男性的自我伤害率随时间呈上升趋势（发病率比=1.04，95%置信区间 1.02-1.06，p<0.0001）。报告的最常见的自我伤害前问题是心理健康（40.5%）和身体健康（38.3%）问题。与 74 岁以上的人相比，60-74 岁的人更常报告与酒精、财务、就业和与伴侣的关系有关的问题。身体健康问题随年龄增长而增加，男性则与酒精有关的问题也增加。十分之一（10.8%）的人在自我伤害指数就诊后 12 个月内因自我伤害再次到医院就诊。
老年男性因自我伤害而到急诊科就诊的人数有所增加，特别是 60-74 岁的男性。预防和临床管理应包括全面的社会心理评估，以针对自我伤害前广泛问题的常见诱因，其中可能包括支持身心健康和关于更安全的饮酒建议。
