Epidemiology and trends in non-fatal self-harm in three centres in England: 2000-2007.
BACKGROUND
Self-harm is a common reason for presentation to a general hospital, with a strong association with suicide. Trends in self-harm are an important indicator of community psychopathology, with resource implications for health services and relevance to suicide prevention policy. Previous reports in the UK have come largely from single centres.


OBJECTIVE
To investigate trends in non-fatal self-harm in six general hospitals in three centres from the Multicentre Study of Self-harm in England, and to relate these to trends in suicide.


METHODS
Data on self-harm presentations to general hospital emergency departments in Oxford (one), Manchester (three) and Derby (two) were analysed over the 8-year period 1 January 2000 to 31 December 2007.


RESULTS
Rates of self-harm declined significantly over 8 years for males in three centres (Oxford: -14%; Manchester: -25%; Derby: -18%) and females in two centres (Oxford: -2% (not significant); Manchester: -13%; Derby: -17%), in keeping with national trends in suicide. A decreasing proportion and number of episodes involved self-poisoning alone, and an increasing proportion and number involved other self-injury (e.g. hanging, jumping, traffic related). Episodes involving self-cutting alone showed a slight decrease in numbers over time. Trends in alcohol use at the time of self-harm and repetition within 1 year were stable.


CONCLUSIONS
There were decreasing rates of non-fatal self-harm over the study period that paralleled trends in suicide in England. This was reflected mainly in a decline in emergency department presentations for self-poisoning.
Centre for Suicide Research, University of Oxford, UK.
Helen
H
Bergen
Keith
K
Hawton
Keith
K
Waters
Jayne
J
Cooper
Navneet
N
Kapur
D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D000428:Alcohol Drinking / Q000453:epidemiology; D004636:Emergency Service, Hospital; D004739:England / Q000453:epidemiology; D005260:Female; D006760:Hospitalization / Q000706:statistics & numerical data; D006769:Hospitals, General; D006801:Humans; D008297:Male; D008875:Middle Aged; D012008:Recurrence; D016728:Self-Injurious Behavior / Q000453:epidemiology*; D012959:Socioeconomic Factors; D013405:Suicide / Q000706:statistics & numerical data / Q000639:trends*; D055815:Young Adult; D000092864:Suicide Prevention