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Non-fatal repetition of self-harm in Taipei City, Taiwan: cohort study

Published online by Cambridge University Press:  02 January 2018

Chi-Leung Kwok ,
Paul S. F. Yip ,
David Gunnell ,
Chian-Jue Kuo  and
Ying-Yeh Chen
Chi-Leung Kwok
Affiliation:
Hong Kong Jockey Club Center for Suicide Research and Prevention, and Department of Social Work and Social Administration, University of Hong Kong, Hong Kong
Paul S. F. Yip
Affiliation:
Hong Kong Jockey Club Center for Suicide Research and Prevention, and Department of Social Work and Social Administration, University of Hong Kong, Hong Kong
David Gunnell
Affiliation:
School of Social and Community Medicine, University of Bristol, UK
Chian-Jue Kuo
Affiliation:
Taipei City Psychiatric Center, Taipei City Hospital, and School of Medicine, Taipei Medical University, Taipei, Taiwan
Ying-Yeh Chen*
Affiliation:
Taipei City Psychiatric Center, Taipei City Hospital, and Institute of Public Health and Department of Public Health, National Yang-Ming University, Taipei, Taiwan
*
Dr Ying-Yeh Chen, 309 Songde Road, Taipei City Psychiatric Center, XinYi District, Taipei, Taiwan. Email: ychen@tpech.gov.tw
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Abstract

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Background

Repeat self-harm is an important risk factor for suicide. Few studies have explored risk factors for non-fatal repeat self-harm in Asia.

Aims

To investigate the risk of non-fatal repeat self-harm in a large cohort of patients presenting to hospital in Taipei City, Taiwan.

Method

Prospective cohort study of 7601 patients with self-harm presenting to emergency departments (January 2004–December 2006). Survival analysis was used to examine the rates, timing and factors associated with repeat self-harm.

Results

In total 778 (10.2%) patients presented to hospital with one or more further episodes of self-harm. The cumulative risk of non-fatal repetition within 1 year of a self-harm episode was 9.3% (95% CI 8.7–10.1). The median time to repetition within 1 year was 105 days. Females had a higher incidence of repeat self-harm than males (adjusted hazard ratio 1.25, 95% CI 1.05–1.48) but males had shorter median time to repetition (107 v. 80 days). Other independent risk factors for repeat self-harm within 1 year of an index episode were: young age, self-harm by medicine overdose and increasing number of repeat episodes of self-harm.

Conclusions

The risk of non-fatal repeat self-harm in Taipei City is lower than that seen in the West. Risk factors for repeat non-fatal self-harm differ from those for fatal self-harm. The first 3 months after self-harm is a crucial period for intervention.

Type
Papers
Information
The British Journal of Psychiatry , Volume 204 , Issue 5 , May 2014 , pp. 376 - 382
Copyright
Copyright © Royal College of Psychiatrists, 2014 

Footnotes

The study was supported by Department of Health, Taipei City Government. The funding agency has no role in the design and conduct of the study; collection, management, analysis and interpretation of the data; and preparation, review or approval of the manuscript. Y-Y.C. was supported by the National Science Council, Taiwan (grant number 101-2314-B-532-005-MY2) and the National Health Research Institute, Taiwan (grant number NHRI-EX100-10024PC). C-L.K. and P.S.F.Y. were supported by a GRF grant of Research Grant Council (HKU-784210).

Declaration of interest

None.

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