Prevalence of non-suicidal self-harm and service contact in England, 2000-14: repeated cross-sectional surveys of the general population.
Prevalence of non-suicidal self-harm and service contact in England, 2000-14: repeated cross-sectional surveys of the general population.
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DOI：
10.1016/s2215-0366(19)30188-9
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发表时间：
2019-07
期刊：
影响因子：
--
通讯作者：
Appleby L
中科院分区：
文献类型：
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作者：
McManus S;Gunnell D;Cooper C;Bebbington PE;Howard LM;Brugha T;Jenkins R;Hassiotis A;Weich S;Appleby L
在英国，自残后到医院急诊室就诊的人数有所增加。然而，大多数自残者不会去医院，因此这种上升是否反映了社区自残流行率的增加尚不清楚。同样未知的是，非自杀性自我伤害（NSSH）或自杀性自我伤害（或两者兼而有之）的患病率是否增加。我们的目的是建立时间趋势的流行NSSH在英格兰。我们分析了2000年（n=7243），2007年（n=6444）和2014年（n=6477）成人精神病发病率调查的参与者的数据，选择了年龄在16-74岁并居住在英格兰的人。我们使用加权数据并控制复杂的调查设计。我们生成的时间趋势，终生患病率和方法，动机，NSSH，以及随之而来的服务联系。我们使用多变量逻辑回归分析来调查与服务接触相关的因素。自我报告的终生NSSH患病率从2000年的2.4%（95% CI 2.0 - 2.8）增加到2014年的6.4%（5.8 - 7.2）。男女和各年龄组的患病率都有所增加，最明显的是16-24岁的妇女和女孩，患病率从2000年的6.5%（4.2 - 10.0）增加到2014年的19.7%（15.7 - 24.5）。2000年至2014年期间，报告NSSH以缓解愤怒，紧张，焦虑或抑郁等不愉快情绪的人口比例在男性和男孩中从1.4%（95%CI 1.0 - 2.0）增加到4.0%（3.2 - 5.0），在女性和女孩中从2.1%（1.6 - 2.7）增加到6.8%（6.0 - 7.8）。2014年，59.4%（95%CI 54.7 - 63.9）参与NSSH的参与者报告没有随后的医疗或心理服务接触，而2000年为51.2%（42.2 - 60.0），2007年为51.8%（47.3 - 56.4）。与女性参与者和老年人相比，男性参与者和16-34岁的人与卫生服务部门接触的可能性更小。在英格兰，NSSH的患病率有所增加，但由此产生的服务接触仍然很低。2014年，大约五分之一的16-24岁女性报告了NSSH。NSSH有潜在的终身影响，例如自杀频率增加，特别是如果这些行为被作为一种长期的应对策略。自残需要与年轻人讨论，而不是将其正常化。年轻人应该得到初级保健，教育和其他服务的帮助，以找到更安全的方法来应对情绪压力。NHS数字，英国卫生和社会保健部，以及国家卫生研究所。
The number of people presenting to hospital emergency departments after self-harming has increased in England. However, most people who self-harm do not present to hospitals, so whether this rise reflects an increase in the prevalence of self-harm in the community is unknown. Also unknown is whether the prevalence of non-suicidal self-harm (NSSH) or suicidal self-harm, or both, has increased. We aimed to establish temporal trends in the prevalence of NSSH in England. We analysed data from participants in the 2000 (n=7243), 2007 (n=6444), and 2014 (n=6477) Adult Psychiatric Morbidity Surveys of the general population, selecting those aged 16–74 years and living in England. We used weighted data and controlled for complex survey design. We generated temporal trends in lifetime prevalence and methods of, and motivations for, NSSH, and consequent service contact. We used multiple variable logistic regression analyses to investigate factors associated with service contact. The prevalence of self-reported lifetime NSSH increased from 2·4% (95% CI 2·0–2·8) in 2000, to 6·4% (5·8–7·2) in 2014. Increases in prevalence were noted in both sexes and across age groups—most notably in women and girls aged 16–24 years, in whom prevalence increased from 6·5% (4·2–10·0) in 2000, to 19·7% (15·7–24·5) in 2014. The proportion of the population reporting NSSH to relieve unpleasant feelings of anger, tension, anxiety, or depression increased from 1·4% (95% CI 1·0–2·0) to 4·0% (3·2–5·0) in men and boys, and from 2·1% (1·6–2·7) to 6·8% (6·0–7·8) in women and girls, between 2000 and 2014. In 2014, 59·4% (95% CI 54·7–63·9) of participants who had engaged in NSSH reported no consequent medical or psychological service contact, compared with 51·2% (42·2–60·0) in 2000 and 51·8% (47·3–56·4) in 2007. Male participants and those aged 16–34 years were less likely to have contact with health services than were female participants and older people. The prevalence of NSSH has increased in England, but resultant service contact remains low. In 2014, about one in five female 16–24-year-olds reported NSSH. There are potential lifelong implications of NSSH, such as an increased frequency of suicide, especially if the behaviours are adopted as a long-term coping strategy. Self-harm needs to be discussed with young people without normalising it. Young people should be offered help by primary care, educational, and other services to find safer ways to deal with emotional stress. NHS Digital, English Department of Health and Social Care, and the National Institute for Health Research.