@article{ref1,
title="Self-harm presentation across healthcare settings by sex in young people: an e-cohort study using routinely collected linked healthcare data in Wales, UK",
journal="Archives of disease in childhood",
year="2019",
author="Marchant, Amanda and Turner, Samantha and Balbuena, Lloyd and Peters, Evyn and Williams, Dave and Lloyd, Keith and Lyons, Ronan and John, Ann",
volume="ePub",
number="ePub",
pages="ePub-ePub",
abstract="BACKGROUND: This study used individual-level linked data across general practice, emergency departments (EDs), outpatients and hospital admissions to examine contacts across settings and time by sex for self-harm in individuals aged 10-24 years old in Wales, UK. <br><br>METHODS: A whole population-based e-cohort study of routinely collected healthcare data was conducted. Rates of self-harm across settings over time by sex were examined. Individuals were categorised based on the service(s) to which they presented. <br><br>RESULTS: A total of 937 697 individuals aged 10-24 years contributed 5 369 794 person years of data from 1 January 2003 to 30 September 2015. Self-harm incidence was highest in primary care but remained stable over time (incident rate ratio (IRR)=1.0; 95% CI 0.9 to 1.1). Incidence of ED attendance increased over time (IRR=1.3; 95% CI 1.2 to 1.5) as did hospital admissions (IRR=1.4; 95% CI 1.1 to 1.6). Incidence in the 15-19 years age group was the highest across all settings. The largest increases were seen in the youngest age group. There were increases in ED attendances for both sexes; however, females are more likely than males to be admitted following this. This was most evident in individuals 10-15 years old, where 76% of females were admitted compared with just 49% of males. The majority of associated outpatient appointments were under a mental health specialty. <br><br>CONCLUSIONS: This is the first study to compare self-harm in people aged 10-24 years across primary care, EDs and hospital settings in the UK. The high rates of self-harm in primary care and for young men in EDs highlight these as important settings for intervention.<br><br>© Author(s) (or their employer(s)) 2019. Re-use permitted under CC BY. Published by BMJ.<p /> <p>Language: en</p>",
language="en",
issn="0003-9888",
doi="10.1136/archdischild-2019-317248",
url="http://dx.doi.org/10.1136/archdischild-2019-317248"
}