Citation

Johnston A, Cooper J, Webb R, Kapur N. Br. J. Psychiatry 2006; 189: 416-421.

Affiliation

Centre for Suicide Prevention, Williamson Building, University of Manchester, Oxford Road, Manchester M13 9PL, UK. nav.kapur@manchester.ac.uk.

Copyright

(Copyright © 2006, Royal College of Psychiatry)

DOI

10.1192/bjp.bp.105.018085

PMID

17077431

Abstract

BACKGROUND: No ecological studies have examined the relationship between area characteristics, individual characteristics and self-harm repetition. AIMS: To investigate the association between area-level factors and incidence and repetition of self-harm, and to identify which area-level factors are independently associated with repetition after adjustment for individual factors. METHOD: Prospective cohort study using the Manchester Self-Harm database. Adults who were resident in Manchester and presented to an emergency department following self-harm between 1997 and 2002 were included (n = 4743). The main outcome measure was repeat self-harm within 6 months of the index episode. RESULTS: Four individual factors (previous self-harm, previous psychiatric treatment, employment status, marital status) and one area-based factor (proportion of individuals who were of White ethnicity) were independently associated with repetition. CONCLUSIONS: Repetition of self-harm may be more strongly related to individual factors than to area characteristics. We need to better understand the processes underlying ecological associations with suicidal behaviour before embarking on area-based interventions.

Language: en