title: Punch injury self-harm in young people.
abstract: Punch injuries are a form of self-harm characterised by the intentional act of striking an object with a closed fist. We aimed to describe the characteristics and trends in young people presenting with injuries sustained via the punch mechanism. A comprehensive retrospective review of medical records was completed of all young people aged 10-18 years presenting to our Central London Emergency Department over a 12-month period. A subset of the total group was identified as the punch injury subgroup. A total of 78 punch injury presentations were identified. In this subgroup, the male:female ratio is 4.57:1; 37.18% of presentations were associated with a fracture ( n = 29) and 35.90% ( n = 28) of patients re-presented following another punch injury, as a victim of violence, or by other psychiatric presentation. In conclusion, a male preponderance was observed, with frequent re-presentations, often in high-risk circumstances. An opportunity for screening, including mental health, social and substance misuse, was identified. Further research is needed to enable targeted effective interventions in this group.
authors.affiliation: Paediatric Mental Health Team, Department of Paediatrics, Whittington Hospital, UK.
authors.forename: Cristal
authors.initials: C
authors.lastname: Oxley
authors.affiliation: Paediatric Mental Health Team, Department of Paediatrics, Whittington Hospital, UK.
authors.forename: Jane E
authors.initials: JE
authors.lastname: Roberts
authors.affiliation: Paediatric Mental Health Team, Department of Paediatrics, Whittington Hospital, UK.
authors.forename: Sebastian
authors.initials: S
authors.lastname: Kraemer
authors.affiliation: Paediatric Mental Health Team, Department of Paediatrics, Whittington Hospital, UK.
authors.forename: Giles
authors.initials: G
authors.lastname: Armstrong
mesh_terms: D000293:Adolescent; D002648:Child; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data*; D005260:Female; D050723:Fractures, Bone / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000209:etiology; D006801:Humans; D008131:London / Q000453:epidemiology; D008297:Male; D012017:Referral and Consultation / Q000706:statistics & numerical data*; D012189:Retrospective Studies; D016728:Self-Injurious Behavior / Q000150:complications / Q000453:epidemiology / Q000209:etiology
keywords: Self-injurious behaviour; adolescent; deliberate self-harm; male; screening