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Thirteen-year follow-up of deliberate self-harm, using linked data

  • David J. Hall (a1), Fiona O'Brien (a2), Cameron Stark (a3), Antony Pelosi (a4) and Helen Smith (a5)...



We describe a national cohort of individuals surviving an episode of deliberate self-harm (DSH). Subsequent admissions for DSH and mortality over the following 13 years were studied.


In 1981, 8304 individuals were discharged from Scottish general hospitals with a diagnosis of attempted suicide (E950–959). They were followed-up to the end of 1994 using the Scottish Linked Data Set. Mortality was compared to the Scottish population using person-years analysis.


2624 people (31.6%) were readmitted with further episodes of DSH. The median number of readmissions was I, range 1–137. The observed: expected ratio for all-cause mortality was 2.26 (95% CI 2.13–2.26). One hundred and sixty-eight people (2%) died from suicide, and 46 (0.6%) from undetermined causes. The observed: expected ratio for suicide plus undetermined deaths was 12.17 (95% CI 10.64-13.91). Accidental deaths in men and homicide deaths in men and women were elevated. The pattern of deaths from other causes suggested that alcohol misuse was a contributory factor.


People admitted to general hospitals in Scotland after attempted suicide are at high risk of readmission for further episodes of DSH. Long-term follow-up of such large cohorts is impractical, but services should review the scope for intervention in alcohol misuse following DSH.


Corresponding author

Cameron Stark, Consultant in Public Health Medicine, Highland Health Board. Beechwood Park, Inverness IV2 3HG


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Thirteen-year follow-up of deliberate self-harm, using linked data

  • David J. Hall (a1), Fiona O'Brien (a2), Cameron Stark (a3), Antony Pelosi (a4) and Helen Smith (a5)...
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