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Quantitative research about self-harm largely deals with self-poisoning,
despite the high incidence of self-injury.
We compared patterns of hospital care and repetition associated with
self-poisoning and self-injury.
Demographic and clinical data were collected in a multicentre,
prospective cohort study, involving 10 498 consecutive episodes of
self-harm at six English teaching hospitals.
Compared with those who self-poisoned, people who cut themselves were
more likely to have self-harmed previously and to have received support
from mental health services, but they were far less likely to be admitted
to the general hospital or receive a psychosocial assessment. Although
only 17% of people repeated self-harm during the 18 months of study,
survival analysis that takes account of all episodes revealed a
repetition rate of 33% in the year following an episode: 47% after
episodes of self-cutting and 31% after self-poisoning (P<0.001). Of
those who repeated, a third switched method of self-harm.
Hospital services offer less to people who have cut themselves, although
they are far more likely to repeat, than to those who have self-poisoned.
Attendance at hospital should result in psychosocial assessment of needs
regardless of method of self-harm.
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