Risk factors for repetition of self-harm: a systematic review of prospective hospital-based studies.

<h4>Background</h4>Self-harm entails high costs to individuals and society in terms of suicide risk, morbidity and healthcare expenditure. Repetition of self-harm confers yet higher risk of suicide and risk assessment of self-harm patients forms a key component of the health care managem...

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Autores principales:	Celine Larkin, Zelda Di Blasi, Ella Arensman
Formato:	article
Lenguaje:	EN
Publicado:	Public Library of Science (PLoS) 2014
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/ed79669217fe40838cb398038f48fc58
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spelling	oai:doaj.org-article:ed79669217fe40838cb398038f48fc582021-11-18T08:37:21ZRisk factors for repetition of self-harm: a systematic review of prospective hospital-based studies.1932-620310.1371/journal.pone.0084282https://doaj.org/article/ed79669217fe40838cb398038f48fc582014-01-01T00:00:00Zhttps://www.ncbi.nlm.nih.gov/pmc/articles/pmid/24465400/pdf/?tool=EBIhttps://doaj.org/toc/1932-6203<h4>Background</h4>Self-harm entails high costs to individuals and society in terms of suicide risk, morbidity and healthcare expenditure. Repetition of self-harm confers yet higher risk of suicide and risk assessment of self-harm patients forms a key component of the health care management of self-harm patients. To date, there has been no systematic review published which synthesises the extensive evidence on risk factors for repetition.<h4>Objective</h4>This review is intended to identify risk factors for prospective repetition of self-harm after an index self-harm presentation, irrespective of suicidal intent.<h4>Data sources</h4>PubMed, PsychInfo and Scirus were used to search for relevant publications. We included cohort studies which examining factors associated with prospective repetition among those presenting with self-harm to emergency departments. Journal articles, abstracts, letters and theses in any language published up to June 2012 were considered. Studies were quality-assessed and synthesised in narrative form.<h4>Results</h4>A total of 129 studies, including 329,001 participants, met our inclusion criteria. Some factors were studied extensively and were found to have a consistent association with repetition. These included previous self-harm, personality disorder, hopelessness, history of psychiatric treatment, schizophrenia, alcohol abuse/dependence, drug abuse/dependence, and living alone. However, the sensitivity values of these measures varied greatly across studies. Psychological risk factors and protective factors have been relatively under-researched but show emerging associations with repetition. Composite risk scales tended to have high sensitivity but poor specificity.<h4>Conclusions</h4>Many risk factors for repetition of self-harm match risk factors for initiation of self-harm, but the most consistent evidence for increased risk of repetition comes from long-standing psychosocial vulnerabilities, rather than characteristics of an index episode. The current review will enhance prediction of self-harm and assist in the efficient allocation of intervention resources.Celine LarkinZelda Di BlasiElla ArensmanPublic Library of Science (PLoS)articleMedicineRScienceQENPLoS ONE, Vol 9, Iss 1, p e84282 (2014)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Celine Larkin Zelda Di Blasi Ella Arensman Risk factors for repetition of self-harm: a systematic review of prospective hospital-based studies.
description	<h4>Background</h4>Self-harm entails high costs to individuals and society in terms of suicide risk, morbidity and healthcare expenditure. Repetition of self-harm confers yet higher risk of suicide and risk assessment of self-harm patients forms a key component of the health care management of self-harm patients. To date, there has been no systematic review published which synthesises the extensive evidence on risk factors for repetition.<h4>Objective</h4>This review is intended to identify risk factors for prospective repetition of self-harm after an index self-harm presentation, irrespective of suicidal intent.<h4>Data sources</h4>PubMed, PsychInfo and Scirus were used to search for relevant publications. We included cohort studies which examining factors associated with prospective repetition among those presenting with self-harm to emergency departments. Journal articles, abstracts, letters and theses in any language published up to June 2012 were considered. Studies were quality-assessed and synthesised in narrative form.<h4>Results</h4>A total of 129 studies, including 329,001 participants, met our inclusion criteria. Some factors were studied extensively and were found to have a consistent association with repetition. These included previous self-harm, personality disorder, hopelessness, history of psychiatric treatment, schizophrenia, alcohol abuse/dependence, drug abuse/dependence, and living alone. However, the sensitivity values of these measures varied greatly across studies. Psychological risk factors and protective factors have been relatively under-researched but show emerging associations with repetition. Composite risk scales tended to have high sensitivity but poor specificity.<h4>Conclusions</h4>Many risk factors for repetition of self-harm match risk factors for initiation of self-harm, but the most consistent evidence for increased risk of repetition comes from long-standing psychosocial vulnerabilities, rather than characteristics of an index episode. The current review will enhance prediction of self-harm and assist in the efficient allocation of intervention resources.
format	article
author	Celine Larkin Zelda Di Blasi Ella Arensman
author_facet	Celine Larkin Zelda Di Blasi Ella Arensman
author_sort	Celine Larkin
title	Risk factors for repetition of self-harm: a systematic review of prospective hospital-based studies.
title_short	Risk factors for repetition of self-harm: a systematic review of prospective hospital-based studies.
title_full	Risk factors for repetition of self-harm: a systematic review of prospective hospital-based studies.
title_fullStr	Risk factors for repetition of self-harm: a systematic review of prospective hospital-based studies.
title_full_unstemmed	Risk factors for repetition of self-harm: a systematic review of prospective hospital-based studies.
title_sort	risk factors for repetition of self-harm: a systematic review of prospective hospital-based studies.
publisher	Public Library of Science (PLoS)
publishDate	2014
url	https://doaj.org/article/ed79669217fe40838cb398038f48fc58
work_keys_str_mv	AT celinelarkin riskfactorsforrepetitionofselfharmasystematicreviewofprospectivehospitalbasedstudies AT zeldadiblasi riskfactorsforrepetitionofselfharmasystematicreviewofprospectivehospitalbasedstudies AT ellaarensman riskfactorsforrepetitionofselfharmasystematicreviewofprospectivehospitalbasedstudies
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Risk factors for repetition of self-harm: a systematic review of prospective hospital-based studies.

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