title: Alcohol use and misuse, self-harm and subsequent mortality: an epidemiological and longitudinal study from the multicentre study of self-harm in England.
abstract: OBJECTIVE
  Alcohol use and misuse are strongly associated with self-harm and increased risk of future self-harm and suicide. The UK general population prevalence of alcohol use, misuse and alcohol-attributable harm has been rising. We have investigated the prevalence of and trends in alcohol use and misuse in self-harm patients and their associations with repeat self-harm and subsequent death.
  
  
  METHODS
  We used patient data from the Multicentre Study of Self-Harm in England for 2000-2009 and UK mortality data for patients presenting from 2000 to 2007 who were followed up to the end of 2009.
  
  
  RESULTS
  Alcohol involvement in acts of self-harm (58.4%) and alcohol misuse (36.1%) were somewhat higher than found previously in self-harm patients. Alcohol involvement and misuse were most frequent in men, those aged 35-54 years and those from white ethnicities. The frequency of alcohol misuse increased between 2000 and 2009, especially in women. Repetition of self-harm was associated with alcohol involvement in self-harm and particularly with alcohol misuse. Risk of suicide was increased significantly in women misusing alcohol.
  
  
  CONCLUSIONS
  Alcohol use and misuse in self-harm patients appears to have increased in recent years, particularly in women. The association of alcohol with greater risk of self-harm repetition and mortality highlights the need for clinicians to investigate alcohol use in self-harm patients. Ready availability of alcohol treatment staff in general hospitals could facilitate appropriate aftercare and the prevention of adverse outcomes.
authors.affiliation: Centre for Research and Development, Derbyshire Healthcare NHS Foundation Trust, Education Centre, Kingsway Site, Derby, UK.
authors.forename: Jennifer
authors.initials: J
authors.lastname: Ness
authors.affiliation: University Department of Psychiatry, Centre for Suicide Research, Department of Psychiatry, University of Oxford, Warneford Hospital, Oxford, UK.
authors.forename: Keith
authors.initials: K
authors.lastname: Hawton
authors.affiliation: University Department of Psychiatry, Centre for Suicide Research, Department of Psychiatry, University of Oxford, Warneford Hospital, Oxford, UK.
authors.forename: Helen
authors.initials: H
authors.lastname: Bergen
authors.affiliation: Centre for Suicide Prevention, University of Manchester, Centre for Mental Health and Risk, Manchester, UK.
authors.forename: Jayne
authors.initials: J
authors.lastname: Cooper
authors.affiliation: Centre for Suicide Prevention, University of Manchester, Centre for Mental Health and Risk, Manchester, UK.
authors.forename: Sarah
authors.initials: S
authors.lastname: Steeg
authors.affiliation: Centre for Suicide Prevention, University of Manchester, Centre for Mental Health and Risk, Manchester, UK.
authors.forename: Navneet
authors.initials: N
authors.lastname: Kapur
authors.affiliation: Centre for Research and Development, Derbyshire Healthcare NHS Foundation Trust, Education Centre, Kingsway Site, Derby, UK.
authors.forename: Martin
authors.initials: M
authors.lastname: Clarke
authors.affiliation: Centre for Research and Development, Derbyshire Healthcare NHS Foundation Trust, Education Centre, Kingsway Site, Derby, UK.
authors.forename: Keith
authors.initials: K
authors.lastname: Waters
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000428:Alcohol Drinking / Q000453:epidemiology*; D000437:Alcoholism / Q000453:epidemiology*; D003430:Cross-Sectional Studies; D004739:England / Q000453:epidemiology; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D012307:Risk Factors; D016728:Self-Injurious Behavior / Q000453:epidemiology* / Q000401:mortality; D012737:Sex Factors; D013405:Suicide / Q000706:statistics & numerical data*; D055815:Young Adult
keywords: alcohol abuse; death/mortality; self harm; suicide