Non-fatal repetition of self-harm in Taipei City, Taiwan: cohort study.
BACKGROUND
Repeat self-harm is an important risk factor for suicide. Few studies have explored risk factors for non-fatal repeat self-harm in Asia.


OBJECTIVE
To investigate the risk of non-fatal repeat self-harm in a large cohort of patients presenting to hospital in Taipei City, Taiwan.


METHODS
Prospective cohort study of 7601 patients with self-harm presenting to emergency departments (January 2004-December 2006). Survival analysis was used to examine the rates, timing and factors associated with repeat self-harm.


RESULTS
In total 778 (10.2%) patients presented to hospital with one or more further episodes of self-harm. The cumulative risk of non-fatal repetition within 1 year of a self-harm episode was 9.3% (95% CI 8.7-10.1). The median time to repetition within 1 year was 105 days. Females had a higher incidence of repeat self-harm than males (adjusted hazard ratio 1.25, 95% CI 1.05-1.48) but males had shorter median time to repetition (107 v. 80 days). Other independent risk factors for repeat self-harm within 1 year of an index episode were: young age, self-harm by medicine overdose and increasing number of repeat episodes of self-harm.


CONCLUSIONS
The risk of non-fatal repeat self-harm in Taipei City is lower than that seen in the West. Risk factors for repeat non-fatal self-harm differ from those for fatal self-harm. The first 3 months after self-harm is a crucial period for intervention.
Chi-Leung Kwok, BSc (ActuarSc), Paul S. F. Yip, PhD, Hong Kong Jockey Club Center for Suicide Research and Prevention, and Department of Social Work and Social Administration, University of Hong Kong, Hong Kong; David Gunnell, MD, PhD, School of Social and Community Medicine, University of Bristol, UK; Chian-Jue Kuo, Taipei City Psychiatric Center, Taipei City Hospital, and School of Medicine, Taipei Medical University, Taipei, Taiwan; Ying-Yeh Chen, MD, ScD, Taipei City Psychiatric Center, Taipei City Hospital, and Institute of Public Health and Department of Public Health, National Yang-Ming University, Taipei, Taiwan.
Chi-Leung
CL
Kwok
Paul S F
PS
Yip
David
D
Gunnell
Chian-Jue
CJ
Kuo
Ying-Yeh
YY
Chen
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015331:Cohort Studies; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D012008:Recurrence; D012307:Risk Factors; D016728:Self-Injurious Behavior / Q000453:epidemiology*; D012737:Sex Factors; D013405:Suicide / Q000706:statistics & numerical data*; D013624:Taiwan / Q000453:epidemiology; D055815:Young Adult