@article{ref1,
title="Predictors for repeat self-harm and suicide among older people within 12 months of a self-harm presentation",
journal="International psychogeriatrics / IPA",
year="2017",
author="Cheung, Gary and Foster, Gisele and Beer, Wayne de and Gee, Susan and Hawkes, Tracey and Rimkeit, Sally and Tan, Yu Mwee and Merry, Sally and Sundram, Frederick",
volume="29",
number="08",
pages="1237-1245",
abstract="BACKGROUND: A past history of self-harm is a significant risk factor for suicide in older people. The aims of this study are to (i) characterize older people who present with self-harm to emergency departments (EDs); and (ii) determine the predictors for repeat self-harm and suicide.    Methods: Demographic and clinical data were retrospectively collected on older people (age 65+ years), who presented to seven EDs in New Zealand following an episode of self-harm between 1st July 2010 and 30th June 2013. In addition, 12-month follow-up information on repeat self-harm and suicide was collected.    Results: The sample included 339 older people (55.2% female) with an age range of 65-96 years (mean age = 75.0; SD = 7.6). Overdose (68.7%) was the most common method of self-harm. 76.4% of the self-harm cases were classified as suicide attempts. Perceived physical illness (47.8%) and family discord (34.5%) were the most common stressors. 12.7% of older people repeated self-harm and 2.1% died by suicide within 12 months. Older people who had a positive blood alcohol reading (OR = 3.87, 95% Cl = 1.35-11.12, p = 0.012) and were already with mental health services at the index self-harm (OR = 2.73, 95% Cl = 1.20-6.25, p = 0.047) were more likely to repeat self-harm/suicide within 12 months.    Conclusion: Older people who self-harm are at very high risk of repeat self-harm and suicide. Screening and assessment for alcohol use disorders should be routinely performed following a self-harm presentation, along with providing structured psychological treatment as an adjunct to pharmacological treatment for depression and interventions to improve the person's resilience resources.<p /> <p>Language: en</p>",
language="en",
issn="1041-6102",
doi="10.1017/S1041610217000308",
url="http://dx.doi.org/10.1017/S1041610217000308"
}