Patients with deliberate self-harm seen by a consultation-liaison service.
OBJECTIVE
To examine Australian trends in deliberate self-harm in order to explore aetiological factors and improve clinical practice.


METHODS
A database recording 5 years of activity of a consultation-liaison service from a large tertiary referral hospital in Sydney was analysed to discover trends in types of self-harm, sex, age, marital status, repetition rates, diagnoses and follow up.


RESULTS
1295 patients with deliberate self-harm were referred to the Service over the 5 years. Of these patients, women exceeded men (ratio of 1.48:1). Self-poisoning constituted 79.5% of the referrals. Rates of self-harm referrals increased from 1999 to 2001, but appeared to plateau in 2002 and 2003. Eighty-eight per cent of referrals were first presentations of self-harm. Most referrals received the diagnosis of adjustment disorder with depressed mood, but a significant proportion was diagnosed with major depressive disorder and schizophrenia, particularly in those that violently self-harmed. There was a significant decline in the rate of admission to hospital over the study period.


CONCLUSIONS
While patient characteristics did not change significantly, there was a decline in admission rates to hospital. Many patients had serious mental illnesses, highlighting the importance of a thorough psychiatric assessment of people who self-harm.
Brakoulias
Vlasios
V
Department of Psychiatry, Westmead Hospital, Westmead, NSW, Australia. vbrakoulias@bigpond.com
Ryan
Christopher
C
Byth
Karen
K
D000328:Adult; D015897:Comorbidity; D003430:Cross-Sectional Studies; D062787:Drug Overdose / Q000175:diagnosis / Q000453:epidemiology / Q000517:prevention & control; D005260:Female; D005500:Follow-Up Studies; D006784:Hospitals, Teaching; D006786:Hospitals, Urban; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000175:diagnosis / Q000453:epidemiology / Q000628:therapy; D009517:New South Wales; D012017:Referral and Consultation / Q000706:statistics & numerical data*; D055502:Secondary Prevention; D016728:Self-Injurious Behavior / Q000175:diagnosis / Q000453:epidemiology* / Q000628:therapy; D013405:Suicide / Q000706:statistics & numerical data*; D000092864:Suicide Prevention