TY  - JOUR
PY  - 2011//
TI  - Shared characteristics of suicides and other unnatural deaths following non-fatal self-harm? A multicentre study of risk factors
JO  - Psychological medicine
A1  - Bergen, Helen A.
A1  - Hawton, Keith E.
A1  - Kapur, N.
A1  - Cooper, J.
A1  - Steeg, S.
A1  - Ness, J.
A1  - Waters, K.
SP  - 1
EP  - 15
VL  - 42
IS  - 4
N2  - BACKGROUND: Mortality, including suicide and accidents, is elevated in self-harm populations. Although risk factors for suicide following self-harm are often investigated, rarely have those for accidents been studied. Our aim was to compare risk factors for suicide and accidents. Method: A prospective cohort (n=30 202) from the Multicentre Study of Self-harm in England, 2000-2007, was followed up to 2010 using national death registers. Risk factors for suicide (intentional self-harm and undetermined intent) and accidents (narcotic poisoning, non-narcotic poisoning, and non-poisoning) following the last hospital presentation for self-harm were estimated using Cox models. RESULTS: During follow-up, 1833 individuals died, 378 (20.6%) by suicide and 242 (13.2%) by accidents. Independent predictors of both suicide and accidents were: male gender, age ⩾35 years (except accidental narcotic poisoning) and psychiatric treatment (except accidental narcotic poisoning). Factors differentiating suicide from accident risk were previous self-harm, last method of self-harm (twofold increased risks for cutting and violent self-injury versus self-poisoning) and mental health problems. A risk factor specific to accidental narcotic poisoning was recreational/illicit drug problems, and a risk factor specific to accidental non-narcotic poisoning and non-poisoning accidents was alcohol involvement with self-harm. CONCLUSIONS: The similarity of risk factors for suicide and accidents indicates common experiences of socio-economic disadvantage, life problems and psychopathology resulting in a variety of self-destructive behaviour. Of factors associated with the accidental death groups, those for non-narcotic poisoning and other accidents were most similar to suicide; differences seemed to be related to criteria coroners use in reaching verdicts. Our findings support the idea of a continuum of premature death.<p />  <p>Language: en</p>
LA  - en
SN  - 0033-2917
UR  - http://dx.doi.org/10.1017/S0033291711001747
ID  - ref1
ER  -