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Deliberate Self-Poisoning and Self-Injury in Children and Adolescents Under 16 Years of Age in Oxford, 1976–1993

  • Keith Hawton, Joan Fagg (a1) and Sue Simkin (a1)



Deliberate self-harm (DSH) is common in adolescents in the United Kingdom and suicide has greatly increased in frequency in older male adolescents. There is, however, very little information about DSH in older children and young adolescents.


Analysis of data collected by the Oxford Monitoring System for Attempted Suicide between 1976 and 1993 for all cases of DSH in under 16-year-olds referred to the general hospital in Oxford.


Seven hundred and fifty-five individuals were involved in 854 episodes of DSH. There were very few cases under 12 years of age but after that the behaviour increased greatly in frequency with each year of age, especially in girls. Eighty-five per cent were girls, the sex ratio being 5.7 girls to each boy. Most cases involved self-poisoning. During the final six years of the study period paracetamol was involved in 54.7% of overdoses, compared with 19.5% in 1976–1981. A minority of individuals had had previous psychiatric treatment. The most frequent problems were relationship difficulties with parents, followed by difficulties with friends, school and social isolation. Among those who reported previous episodes of DSH, in the majority of cases these had not come to medical attention. Repetition of self-harm occurred in 9.4% of cases within a year of an episode and 19.3% during the overall study period. There was some indication that repetition was most common in youngsters discharged from the Accident and Emergency Department without a psychiatric assessment.


DSH in under 16-year-olds is not uncommon and there is evidence that it occurs far more frequently in the community than is reflected in general hospital figures. The problem of paracetamol self-poisoning in this age group needs to be addressed. A psychiatric assessment should be performed in all cases coming to the general hospital.


Corresponding author

Dr Keith Hawton, University Department of Psychiatry, Warneford Hospital, Oxford OX3 7JX


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Choquet, M., Facy, F. & Davidson, F. (1980) Suicide and attempted suicide among adolescents in France. In The Suicide Syndrome (eds Farmer, R. D. T. & Hirsch, S.), pp. 7389. London: Groom Helm.
Hawton, K. (1986) Suicide and Attempted Suicide among Children and Adolescents. Newbury Park: Sage.
Hawton, K. (1992) By their own young hand: suicide is increasing rapidly in young men (Editorial). British Medical Journal, 304, 1000.
Hawton, K. & Goldacre, M. (1982) Hospital admissions for adverse effects of medicinal agents (mainly self-poisoning) among adolescents in the Oxford region. British Journal of Psychiatry, 141, 166170.
Hawton, K., O'Grady, J., Osborn, M., et al (1982) Adolescents who take overdoses: their characteristics, problems and contacts with helping agencies. British Journal of Psychiatry, 140, 118123.
Hawton, K. & Fagg, J. (1992a) Trends in deliberate self-poisoning and self-injury in Oxford, 1976–1990. British Medical Journal, 304, 14091411.
Hawton, K. & Fagg, J. (1992b) Deliberate self-poisoning and self-injury in adolescents: a study of characteristics and trends in Oxford, 1976–1989. British Journal of Psychiatry, 161, 816823.
Hawton, K., Ware, C., Mistry, H., et al (1996) Paracetamol self-poisoning: characteristics, prevention and harm reduction. British Journal of Psychiatry, 168, 4348.
Kerpoot, M., Dyer, E., Harrington, V., et al (1996) Correlates and short-term course of self-poisoning in adolescents. British Journal of Psychiatry, 168, 3842.
Kienhorst, C. W. M., Wolters, W. H. G., Diekstra, R. F. W., et al (1987) A study of the frequency of suicidal behaviour in children aged 5 to 14. Journal of Child Psychiatry and Psychology, 28, 153165.
Kienhorst, C. W. M., de Wilde, E. J., Broese van Groenou, M. I., et al (1990) Self-reported suicidal behavior in Dutch secondary education students. Suicide and Life-Threatening Behavior, 20, 101112.
Kreitman, N. & Schreiber, M. (1979) Parasuicide in young Edinburgh women, 1968–75. Psychological Medicine, 9, 469479.
McClure, G. M. G. (1994) Suicide in children and adolescents in England and Wales 1960–1990. British Journal of Psychiatry, 165, 510514.
Royal College of Psychiatrists (1982) The management of parasuicide in young people under sixteen. Bulletin of the Royal College of Psychiatrists, 6, 182185.
Schmidtke, A., Bille-Brahe, U., DeLeo, D., et al (1994) Rates and trends of attempted suicide in Europe 1989–1992. In Attempted Suicide in Europe: Findings from the Multicentre Study on Parasuicide by the WHO Regional Office for Europe (eds Kerkhof, A. J. F. M., Schmidtke, A., Bille-Brahe, U., et al). DSWO Press: Leiden University.
Sellar, C., Goldacre, M. J. & Hawton, K. (1990a) Reliability of routine hospital data on poisoning as measures of deliberate self-poisoning in adolescents. Journal of Epidemiology and Community Health, 44, 313315.
Sellar, C., Hawton, K. & Goldacre, M. J. (1990b) Self-poisoning in adolescents: hospital admissions and deaths in the Oxford Region 1980–85. British Journal of Psychiatry, 156, 866–470.
Schaffer, D. (1994) Implications for education: prevention of young suicide. In The Prevention of Suicide (eds Jenkins, R., Griffiths, S., Wylie, I., et al), pp. 163173. London: HMSO.
SPSS Inc (1983) SPSSX Users' Guide. New York: McGraw Hill.
Taylor, E. A. & Stansfield, S. A. (1984) Children who poison themselves I. Clinical comparison with controls. British Journal of Psychiatry, 145, 27131.
White, H. C. (1974) Self-poisoning in adolescents. British Journal of Psychiatry, 124, 2435.


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Deliberate Self-Poisoning and Self-Injury in Children and Adolescents Under 16 Years of Age in Oxford, 1976–1993

  • Keith Hawton, Joan Fagg (a1) and Sue Simkin (a1)
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