Deliberate self-harm in Oxford, 1990-2000: a time of change in patient characteristics.
BACKGROUND
Trends in deliberate self-harm (DSH) are important because they have implications for hospital services, may indicate levels of psychopathology in the community and future trends in suicide, and can assist in identification of means of suicide prevention.


METHODS
We have investigated trends in DSH and characteristics of DSH patients between 1990 and 2000 based on data collected through the Oxford Monitoring System for Attempted Suicide.


RESULTS
During the 11-year study period 8590 individuals presented following 13858 DSH episodes. The annual numbers of persons and episodes increased overall by 36.3% and 63.1% respectively. Rates (Oxford City) declined, however, in the final 3 years. There were gender- and age-specific changes, with a rise in DSH rates in males aged > or = 55 years and in females overall and those aged 15-24 years and 35-54 years. Repetition of DSH increased markedly during the study period. Antidepressant overdoses, especially of SSRIs, increased substantially. Paracetamol overdoses declined towards the end of the study period. Alcohol abuse, use of alcohol in association with DSH, and violence increased, especially in females, and the proportion of patients in current psychiatric care and misusing drugs also rose.


CONCLUSIONS
While overall rates of DSH did not increase markedly between 1990 and 2000, substantial changes in the characteristics of the DSH population and a rise in repetition suggest that the challenges facing clinical services in the management of DSH patients have grown.
Hawton
K
K
Centre for Suicide Research, University of Oxford, Department of Psychiatry, Warneford Hospital, Headington, Oxford.
Harriss
L
L
Hall
S
S
Simkin
S
S
Bale
E
E
Bond
A
A
D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D002391:Catchment Area, Health; D005260:Female; D006801:Humans; D008297:Male; D017533:Marital Status; D008875:Middle Aged; D015995:Prevalence; D012008:Recurrence; D012189:Retrospective Studies; D016728:Self-Injurious Behavior / Q000453:epidemiology* / Q000523:psychology; D017678:Sex Distribution; D012923:Social Class; D014478:Unemployment / Q000706:statistics & numerical data; D006113:United Kingdom / Q000453:epidemiology