title: Severity of hospital-treated self-cutting and risk of future self-harm: a national registry study.
abstract: BACKGROUND
  Risk assessment forms a key component in self-harm management. Among self-harm presentations generally, lethality of an index act is a poor predictor of future non-fatal repetition. However, no study has examined whether severity of an index self-cutting episode is associated with prospective repetition.
  
  
  OBJECTIVE
  To examine factors associated with severity of self-cutting and in particular the association between severity of self-cutting and prospective repetition of self-harm.
  
  
  METHODS
  All index self-cutting presentations to emergency departments in Ireland over 5 years were grouped by treatment received and compared on the basis of demographic and clinical characteristics.
  
  
  RESULTS
  Receiving more extensive medical treatment was associated with male gender, being aged more than 15 years, and not combining self-harm methods. Receiving less extensive treatment conferred a higher risk of prospective 12-month repetition, even after controlling for demographic and clinical characteristics. Repeat self-harm presentations by those with more severe self-cutting in an index act were less prevalent but were more likely to involve high-lethality methods of self-harm.
  
  
  CONCLUSIONS
  The results indicate that the already-elevated repetition risk among self-cutting patients is further increased for those receiving less extensive wound closure treatment. Severity of self-cutting might also affect suicide risk but such an association has yet to be examined.
authors: National Suicide Research Foundation and.
authors: Celine
authors: C
authors: Larkin
authors: Paul
authors: P
authors: Corcoran
authors: Ivan
authors: I
authors: Perry
authors: Ella
authors: E
authors: Arensman
mesh_terms: D000293:Adolescent; D000328:Adult; D005260:Female; D006760:Hospitalization; D006801:Humans; D007494:Ireland; D008297:Male; D008875:Middle Aged; D012042:Registries; D012307:Risk Factors; D016728:Self-Injurious Behavior / Q000175:diagnosis / Q000453:epidemiology*; D015599:Trauma Severity Indices; D055815:Young Adult