Risk for suicide increased in children, teens who self-harm

(HealthDay)—Children and adolescents who self-harm have an increased risk for suicide, according to a study published online Jan. 8 in The Lancet Child & Adolescent Health.

Keith Hawton, D.Sc., D.M., from the University of Oxford in the United Kingdom, and colleagues analyzed data from 9,173 individuals aged 10 to 18 years who presented to the emergency department of five study hospitals after nonfatal self-harm between Jan. 1, 2000, and Dec. 31, 2013.

The researchers found that 124 individuals had died by the end of follow-up on Dec. 31, 2015. Of these individuals, 44, 22, and 34 percent died by suicide, accidental death, and death by other causes, respectively. Eighty-two percent of suicide deaths involved self-injury. Method witching between self-harm and suicide occurred frequently, especially from poisoning to hanging or asphyxiation. In this cohort, the 12-month incidence of suicide was significantly increased compared with the expected rate in the general population of 10- to 18-year-olds in England (standardized mortality ratio, 31.0; 95 percent confidence interval, 15.5 to 61.9). Suicide risk was increased in association with male sex, presenting for self-harm as an older adolescent, use of self-injury for self-harm, especially hanging or asphyxiation, and repeated self-harm (adjusted hazard ratios [95 percent confidence intervals], 2.50 [1.46 to 4.26], 1.82 [0.93 to 3.54], 2.11 [1.17 to 3.81], 4.90 [1.47 to 16.39], and 1.87 [1.10 to 3.20], respectively).

"A clear need exists to identify preventive interventions that might reduce risk of self-harm in children and adolescents, repetition of the behavior, and premature death due to suicide and other preventable causes in the self-harm population," the authors write.

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