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Background stressors and deliberate self-harm

Prospective case note study in southern Ireland

^*Helen S. Keeley Research Psychiatrist, National Suicide Research Foundation, 1 Perrott Avenue, College Road, Cork, Ireland and Consultant Child and Adolescent Psychiatrist, Brothers of Charity, Southern Services, Child and Adolescent Mental Health Services, Mahon, Blackrock, Cork, Ireland, Mary O'Sullivan Research Psychologist, Regional Development Unit, Limerick, Ireland, Paul Corcoran Research Statistician, National Suicide Research Foundation, Cork, Ireland

AIMS AND METHOD

In this study we aimed to identify negative life events, especially those associated with repetition, in the background histories of patients in a 2-year prospective monitoring study of hospital-treated deliberate self-harm (DSH). Thematic analysis of the narratives recorded during assessment was used to produce general categories of life events.

RESULTS

In 3031 DSH episodes (n=2287 individuals), women reported more life events than men. Family and interpersonal problems were most commonly reported. Reporting a dysfunctional family of origin, a history of sexual abuse and the imprisonment of self or other were associated with repetition retrospectively and prospectively.

CLINICAL IMPLICATIONS

The background history of patients who harm themselves should be explored routinely on assessment in order to help establish risk of repetition and to determine appropriate follow-up.