TY  - JOUR
PY  - 2013//
TI  - Method choice in nonfatal self-harm as a predictor of subsequent episodes of self-harm and suicide: implications for clinical practice
JO  - American journal of public health
A1  - Miller, Matthew C.
A1  - Hempstead, Katherine
A1  - Nguyen, Tuan
A1  - Barber, Catherine
A1  - Rosenberg-Wohl, Sarah
A1  - Azrael, Deborah R.
SP  - e61
EP  - 8
VL  - 103
IS  - 6
N2  - Objectives. We examined time-varying and time-invariant characteristics of nonfatal intentional self-harm episodes in relation to subsequent episodes of self-harm and suicide. Methods. We conducted a follow-up cohort study through 2007 of 3600 patients discharged from hospitals in New Jersey with a primary diagnosis of intentional self-harm in 2003. We determined repetition of self-harm from hospital records and suicide from state registers. Results. Use of methods other than drug overdose and cutting in self-harm events, greater medical severity of nonfatal episodes, and a history of multiple self-harm episodes increased the risk of suicide. However, most suicides occurred without these risk factors. Most suicides took place without intervening episodes of self-harm, and most persons used a low-lethality method (drug overdose or cutting) in their index episode, but switched to a more lethal method in their fatal episode. Conclusions. Our findings suggest that preventing suicide among persons with a history of self-harm must account for the possibility that they will adopt methods with higher case-fatality ratios than they previously tried. (Am J Public Health. Published online ahead of print April 18, 2013: e1-e8. doi:10.2105/AJPH.2013.301326).<p />  <p>Language: en</p>
LA  - en
SN  - 0090-0036
UR  - http://dx.doi.org/10.2105/AJPH.2013.301326
ID  - ref1
ER  -