Repetition of self-poisoning and self-injury: a retrospective 4-year study

Objectives

Repetition of self-poisoning and self-injury presents us serious problems because there are some important reasons. Not only may it represent the establishment of a maladaptive pattern of coping, but it also the probability of fatal suicide. The purpose of this study was to investigate characteristics of patients who attempted suicide repeatedly.

Methods

This study was undertaken in the emergency department of Fukushima Medical University Hospital. We conducted a retrospective cohort study of consecutive patients with attempting suicide for over 4-years period between April 1996 and March 2000. Patients who attempted suicide were picked up from the records of emergency room and then all records where the attending doctor diagnosed self-poisoning and self-harm were identified.

Results

The total number of attempters of suicide was 215 (0.38%, whom 74 were men and 141 women (male to female ratio 1:1.9). Of these, the number of repeaters was 41, whom 5 were men and 36 women. Repeaters tend to be younger, particularly, 64% of repeaters in women were under 30 years old. Overdoses of drug and poison were most frequently in single presenters. In repeaters, repetition of overdose was most frequent combinations, particularly, 63.9% of repeaters in women attempted overdose of drugs. Significantly more repeat presentation in women were triaged to the low priority categories and survival ratio of this group was highest. There were no tendencies in psychiatric diagnosis of repeaters, however, young women were frequently diagnosed personality disorder. First repeats were found to occur more frequently in the 3 months following the original attempt for the half of patients.

Conclusions

This study concludes that there are some significant differences between patients who attempt suicide repeatedly and those who attempt on one occasion only. To arrange suitable after-care, the doctors who are in charge of emergency department should train to assess and manage patients of self-poisoning or self-harm in collaboration of the psychiatric services.