Subsequent deliberate self-harm in patients referred to a psychiatrist: a prospective study.

One thousand and five patients referred to a psychiatrist were questioned, during a routine clinical interview, about current and previous suicidal ideas and previous suicide behaviour; they were also specifically asked what made life worth living for them at the time. In a four-year case-record follow-up 102 patients (10.1 per cent) were found subsequently to have attempted deliberately to harm themselves. Such deliberate self-harm (DSH) was significantly associated with female sex, with age below 35, and with evidence of suicidal ideation and/or behavior at the time of and/or before the initial referral. To the question, "What makes life worth living for you at the present time?" a significant number of subsequent life-harmers had answered 'Nothing' or 'Not much' while a significant number of subsequent non-self-harmers had answered "Spouse and children" or "Family". The results suggest that the answers to questions about current and previous suicidal ideas and behaviour and perceptions of what makes life worth living may be useful in the prediction of deliberate self-harm.