Repeat Self-Harm Following Hospital-Presenting Intentional Drug Overdose among Young People—A National Registry Study
Abstract
:1. Introduction
2. Materials and Methods
2.1. Setting and Sample
2.2. Data Items
2.3. Statistical Analyses and Reporting
3. Results
3.1. Characteristics of Index and Repeat Self-Harm Presentations
3.2. Characteristics of Repeat Presentations Following an Index Episode of IDO
3.3. Methods Used in Self-Harm Repetition
4. Discussion
5. Conclusions
Supplementary Materials
Author Contributions
Funding
Acknowledgments
Conflicts of Interest
References
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Presentation Characteristics | Total Cohort: N = 16,800 | Individuals Repeating with Any Method: N = 2136 | Univariate Model | Multivariate Model f | ||
---|---|---|---|---|---|---|
N | N (%) | HR (95% CI) | p | HR (95% CI) | p | |
Gender | ||||||
Male | 6197 | 874 (14.1) | 1.21 (1.11–1.31) | ≤0.001 | 1.13 (1.03–1.24) | 0.009 |
Female | 10,603 | 1262 (11.9) | 1.00 | – | 1.00 | – |
Age | ||||||
10–17 yrs | 6357 | 862 (13.6) | 1.12 (1.02–1.22) | 0.012 | 1.29 (1.18–1.41) | ≤0.001 |
18–24 yrs | 10,443 | 1274 (12.2) | 1.00 | – | 1.00 | – |
Number of Drug Types a | ||||||
Single drug IDO | 7901 | 1065 (12.0) | 0.89 (0.81–0.96) | 0.005 | 0.97 (0.88–1.06) | 0.493 |
Multiple drug IDO | 8897 | 1071 (13.6) | 1.00 | – | 1.00 | – |
Number of Tablets b | ||||||
0–19 | 6733 | 812 (12.1) | 1.00 | – | 1.00 | – |
20–49 | 4984 | 623 (12.5) | 1.03 (0.93–1.15) | 0.543 | 1.05 (0.94–1.17) | 0.391 |
≥50 | 1236 | 190 (15.4) | 1.30 (1.11–1.52) | 0.001 | 1.27 (1.07–1.49) | 0.005 |
Drug Type c | ||||||
Analgesic | 7075 | 767 (10.8) | 0.75 (0.69–0.82) | ≤0.001 | 0.92 (0.79–1.07) | 0.261 |
Benzodiazepine | 3332 | 598 (17.9) | 1.64 (1.50–1.81) | ≤0.001 | 1.67 (1.40–1.98) | ≤0.001 |
Antidepressant | 2737 | 421 (15.4) | 1.29 (1.16–1.44) | ≤0.001 | 1.36 (1.18–1.56) | ≤0.001 |
Anxiolytic | 2238 | 391 (17.5) | 1.53 (1.37–1.71) | ≤0.001 | 0.97 (0.81–1.15) | 0.709 |
Illegal drugs | 1259 | 178 (14.1) | 1.14 (0.98–1.33) | 0.096 | 0.97 (0.82–1.15) | 0.728 |
Antiepileptic | 606 | 107 (17.7) | 1.43 (1.18–1.74) | ≤0.001 | 1.25 (1.02–1.54) | 0.035 |
Opioid | 552 | 75 (13.6) | 1.08 (0.86–1.36) | 0.517 | – | – |
Other drugs | 5042 | 604 (12.0) | 0.91 (0.83–1.00) | 0.055 | 1.10 (0.93–1.30) | 0.274 |
Method/s | ||||||
IDO alone | 14,691 | 1789 (12.2) | 1.00 | – | 1.00 | – |
IDO and self-cutting | 1464 | 240 (16.4) | 1.40 (1.22–1.60) | ≤0.001 | 1.37 (1.20–1.58) | ≤0.001 |
IDO and hanging | 236 | 41 (17.4) | 1.47 (1.08–2.00) | 0.015 | 1.28 (0.93–1.76) | 0.129 |
IDO and unspecified method | 154 | 21 (13.6) | 1.17 (0.76–1.80) | 0.467 | 1.11 (0.71–1.71) | 0.650 |
IDO and poisoning | 99 | 16 (16.2) | 1.36 (0.83–2.22) | 0.224 | 1.25 (0.77–2.05) | 0.365 |
IDO and drowning | 61 | 8 (13.1) | 1.15 (0.57–2.30) | 0.697 | 1.09 (0.54–2.21) | 0.811 |
Alcohol Involved d | 4534 | 577 (12.7) | 0.99 (0.90–1.09) | 0.897 | – | – |
Recommended Next Care | ||||||
Admitted to a ward | 5556 | 728 (13.1) | 1.10 (1.00–1.21) | 0.046 | 1.09 (0.99–1.20) | 0.079 |
Admitted to psychiatric ward or unit | 567 | 110 (19.4) | 1.67 (1.37–2.03) | ≤0.001 | 1.51 (1.24–1.85) | ≤0.001 |
Refused or left without being seen | 1702 | 225 (13.2) | 1.11 (0.96–1.28) | 0.157 | 1.08 (0.93–1.25) | 0.315 |
Not admitted | 8975 | 1073 (12.0) | 1.00 | – | 1.00 | – |
Mental Health Assessment e | ||||||
No | 2337 | 295 (12.6) | 0.97 (0.85–1.11) | 0.689 | – | – |
Yes | 6501 | 842 (13.0) | 1.00 | – | – | – |
Presentation Characteristics | Individuals Who Repeated N = 2136 | Individuals Who Switched Method N = 378 | Univariate Model | Multivariate Model d | |||
---|---|---|---|---|---|---|---|
N | N (%) | RR (95% CI) | p | RR (95% CI) | p | ||
Gender | Male | 874 | 194 (22.2) | 1.52 (1.27–1.83) | ≤0.001 | 1.36 (1.11–1.66) | 0.006 |
Female | 1262 | 184 (14.6) | 1.00 | – | – | – | |
Age | 10–17 yrs | 862 | 136 (15.8) | 0.83 (0.69–1.01) | 0.083 | 0.89 (0.73–1.09) | 0.309 |
18–24 yrs | 1274 | 242 (19.0) | 1.00 | – | |||
Number of Drug Types a | Single drug IDO | 1065 | 207 (19.4) | 1.22 (1.01–1.46) | 0.057 | 1.25 (1.03–1.52) | 0.045 |
Multiple drug IDO | 1071 | 171 (16.0) | 1.00 | – | – | – | |
Number of Tablets b | 0–19 | 812 | 124 (15.3) | 1.00 | – | – | – |
20–49 | 623 | 108 (17.3) | 1.14 (0.89–1.44) | 0.335 | – | – | |
50+ | 190 | 27 (14.2) | 0.93 (0.63–1.37) | 0.735 | – | – | |
Drug Type | Analgesic | 767 | 118 (15.4) | 0.81 (0.66–0.99) | 0.058 | 1.01 (0.79–1.31) | 0.925 |
Benzodiazepine | 598 | 103 (17.2) | 0.96 (0.78–1.18) | 0.746 | – | – | |
Antidepressant | 421 | 61 (14.5) | 0.78 (0.61–1.01) | 0.082 | 0.93 (0.70–1.24) | 0.657 | |
Illegal drugs | 178 | 54 (30.3) | 1.83 (1.43–2.34) | ≤0.001 | 1.63 (1.25–2.14) | 0.003 | |
Anxiolytic | 391 | 64 (16.4) | 0.91 (0.71–1.16) | 0.490 | – | – | |
Antiepileptic | 107 | 19 (17.8) | 1.00 (0.66–1.53) | 0.988 | – | – | |
Opioid | 75 | 11 (14.7) | 0.82 (0.47–1.43) | 0.526 | – | – | |
Other drugs | 604 | 126 (20.9) | 1.27 (1.05–1.54) | 0.029 | 1.10 (0.86–1.41) | 0.498 | |
Alcohol Involved | Yes | 577 | 113 (19.6) | 1.15 (0.94–1.41) | 0.208 | – | – |
Recommended Next Care | Admitted to a ward | 728 | 125 (17.2) | 1.02 (0.83–1.25) | 0.879 | – | – |
Admitted to psychiatric ward or unit | 110 | 20 (18.2) | 1.08 (0.71–1.64) | 0.750 | – | – | |
Refused or left without being seen | 225 | 52 (23.1) | 1.37 (1.04–1.80) | 0.045 | 1.23 (0.94–1.62) | 0.191 | |
Not admitted | 1073 | 181 (16.9) | 1.00 | – | – | – | |
Mental Health Assessment c | No | 295 | 49 (16.6) | 0.92 (0.67–1.23) | 0.612 | – | – |
Yes | 842 | 152 (18.1) | 1.00 | – | – | – |
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Share and Cite
Daly, C.; Griffin, E.; McMahon, E.; Corcoran, P.; Webb, R.T.; Witt, K.; Ashcroft, D.M.; Arensman, E. Repeat Self-Harm Following Hospital-Presenting Intentional Drug Overdose among Young People—A National Registry Study. Int. J. Environ. Res. Public Health 2020, 17, 6159. https://doi.org/10.3390/ijerph17176159
Daly C, Griffin E, McMahon E, Corcoran P, Webb RT, Witt K, Ashcroft DM, Arensman E. Repeat Self-Harm Following Hospital-Presenting Intentional Drug Overdose among Young People—A National Registry Study. International Journal of Environmental Research and Public Health. 2020; 17(17):6159. https://doi.org/10.3390/ijerph17176159
Chicago/Turabian StyleDaly, Caroline, Eve Griffin, Elaine McMahon, Paul Corcoran, Roger T. Webb, Katrina Witt, Darren M. Ashcroft, and Ella Arensman. 2020. "Repeat Self-Harm Following Hospital-Presenting Intentional Drug Overdose among Young People—A National Registry Study" International Journal of Environmental Research and Public Health 17, no. 17: 6159. https://doi.org/10.3390/ijerph17176159