How Often Does Deliberate Self-Harm Occur Relative to Each Suicide? A Study of Variations by Gender and Age
How Often Does Deliberate Self-Harm Occur Relative to Each Suicide? A Study of Variations by Gender and Age
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DOI：
10.1521/suli.2008.38.6.650
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发表时间：
2008-12-01
影响因子：
3.2
通讯作者：
Harriss, Louise
中科院分区：
文献类型：
--
作者：
Hawton, Keith;Harriss, Louise
故意自残（DSH;即，非致命性的自我中毒或自我伤害）比自杀发生得更频繁，但对DSH和自杀的比较率几乎没有详细的调查。我们进行了一项研究，如何在整个生命周期的性别和方法的DSH率与自杀率的DSH率的估计，使用10年的数据，从一个地方系统监测DSH介绍给综合医院和国家和地方自杀统计。基于DSH年发病率，DSH与自杀的比率为36（95% CI 34.9-37.1），女性（87.9; 9.5% CI 84.4-91.6）比男性（18.7; 95% CI 17.9-19.6）高近5倍。该比率在整个生命周期中变化很大，从青少年的200多人下降到60岁及以上的人的不到10人。在整个生命周期中，男女比例的差异也在缩小。当使用当地自杀率时，也有非常相似的发现。当分析数据时，这些模式被复制，首先，基于研究期间的所有DSH发作，但是DSH：自杀比率更大（例如，整体52.7; 95%CI 51.4-54.1），第二，基于研究期间仅从事DSH的个体，但比例较小（例如，总体26.2; 95% CI 25.4-27.2）。高自杀意图和低自杀意图者的DSH：自杀率比率在年龄组内相似，但60岁及以上的人除外，其中有更大比例的高意图行为。这些发现说明了自我伤害行为的性质如何在整个生命周期和性别之间的意图有所不同，并为进一步的此类比较工作提供了基础。
Deliberate self-harm (DSH; i.e., nonfatal self-poisoning or self-injury) occurs much more frequently than suicide, yet there has been little detailed investigation of the comparative rates of DSH and suicide. We conducted a study of how rates of DSH relate to suicide rates across the life cycle by gender and by method of estimation of DSH rates, using 10 years of data from a local system for monitoring DSH presentations to a general hospital and national and local suicide statistics. The rate-ratio of DSH to suicide was 36 (95% CI 34.9-37.1) based on annual person-based rates of DSH episodes and was nearly five times higher in females (87.9; 9.5% CI 84.4-91.6) than in males (18.7; 95% CI 17.9-19.6). The ratio varied markedly across the life cycle, decreasing from more than 2 00 in teenagers to less than 10 in persons aged 6 0 years and over. The difference in the ratio between females and males also decreased over the life cycle. There were very similar findings when local suicide rates were used. These patterns were replicated when the data were analyzed, first, on the basis of all episodes of DSH during the study period, but with expectedly larger DSH:suicide ratios (e.g., overall 52.7; 95% CI 51.4-54.1), and second, on the basis of individual persons only engaging in DSH during the study period, but with smaller ratios (e.g., overall 26.2; 95% CI 25.4-27.2). The DSH:suicide rate ratios for those with high and low suicidal intent were similar within age groups except for those aged 60 years and over, in whom there was a greater proportion of high intent acts. These findings illustrate how the nature of self-harming behavior may vary in intention across the life cycle and between the genders, and provide a basis for further comparative work of this kind.