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Following self-harm, there are shared and differing risk factors for subsequent suicide death or accidental death

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Question: In people who have self-harmed, what are the risk factors for subsequent suicide and for accidental death?

People: 30 202 individuals who presented to hospital emergency departments with non-fatal self-harm between 2000 and 2007 who were part of the Multicentre Study of Self-harm in England. Self-harm was defined as intentional self-poisoning or injury, regardless of motivation. A total of 59% were females with a median age of 27 years; 41% were males with a median age of 31 years.

Setting: Six hospitals; three cities (Oxford, Manchester and Derby), England; 2000–2010.

Risk factors: Risk factors included gender, age, unemployment, sickness, disability, self-reported previous self-harm, alcohol involvement within 6 h of self-harm, method of self-harm, current or previous psychiatric treatment, psychosocial assessment and precipitating factors in the last episodes of self-harm (eg, alcohol, relationship, illicit drug, mental health, financial or bereavement problems). Data on risk factors were collected by clinicians using standard forms during psychosocial assessment in the emergency department, or extracted from medical records by research clerks. Factors which were significant in univariate analyses (at p<0.2) were entered in multivariate models.

Outcomes: Suicide …

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