Deliberate self-harm by under-15-year-olds: characteristics, trends and outcome.
BACKGROUND
Relatively little information is available about the characteristics and long-term outcome of children and adolescents aged under 15 years who present to general hospitals because of deliberate self-harm (DSH).


METHODS
Information was collected on 710 consecutive under-15-year-olds presenting to a general hospital in central England with DSH over a 26-year period (1978-2003). Outcome in terms of death was investigated from national statistics in 464 cases presenting during the first 20 years of the study.


RESULTS
Most individuals were aged 12-14 years. In this age group the female:male ratio was 6.5:1. Nearly all (680/710, 95.8%) had taken overdoses, over half of these episodes involving paracetamol (acetaminophen). Few had a history of prior (7.7%) or current psychiatric treatment (7.7%), although a quarter (150/559, 26.8%) had a history of previous DSH. Suicidal intent was usually low. The most frequent problems were difficulties in relationships with family members (77.3%) and with friends (38.9%), and school/study problems (37.9%). The long-term risk of suicide was low, 1.1% (N = 5) having died by probable suicide after a mean follow-up period of 11 years 2 months.


CONCLUSIONS
DSH in children and young adolescents is usually related to life problems, is generally of low suicidal intent, and is associated with a relatively low long-term risk of suicide.
Hawton
Keith
K
Centre for Suicide Research, Department of Psychiatry, University of Oxford, UK. keith.hawton@psych.ox.ac.uk
Harriss
Louise
L
D000293:Adolescent; D000328:Adult; D000437:Alcoholism / Q000175:diagnosis / Q000453:epidemiology / Q000401:mortality / Q000523:psychology; D002423:Cause of Death; D015897:Comorbidity; D019548:Crime Victims / Q000523:psychology / Q000706:statistics & numerical data; D003430:Cross-Sectional Studies; D062787:Drug Overdose / Q000175:diagnosis / Q000453:epidemiology* / Q000401:mortality / Q000523:psychology; D004739:England; D054541:Family Conflict / Q000523:psychology; D005260:Female; D005500:Follow-Up Studies; D006769:Hospitals, General / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D010552:Personality Assessment; D010555:Personality Inventory; D011567:Psychiatric Department, Hospital / Q000706:statistics & numerical data; D012008:Recurrence; D012306:Risk; D012307:Risk Factors; D016728:Self-Injurious Behavior / Q000175:diagnosis / Q000453:epidemiology* / Q000401:mortality / Q000523:psychology; D012959:Socioeconomic Factors; D019966:Substance-Related Disorders / Q000175:diagnosis / Q000453:epidemiology / Q000401:mortality / Q000523:psychology; D013405:Suicide / Q000639:trends*; D013406:Suicide, Attempted / Q000523:psychology / Q000639:trends*; D014754:Violence / Q000523:psychology / Q000706:statistics & numerical data