Abstract
Abstract: Previous self-harm has been identified as a risk factor for subsequent suicide by adolescents. The objective of the study was to identify further risk factors for subsequent premature death and suicide in a population of adolescents presenting with self-poisoning. A longitudinal cohort design using data-linkage of consecutive adolescent patients presenting to the Hunter Area Toxicology Service, a regional toxicology service for Newcastle, Australia, with the National Death Index of the Australian Institute of Health and Welfare was used. A total of 441 adolescents aged 10 to 19 years presented with self-poisoning over 5 years from January 1991 to December 1995, with follow-up to March 2001. There were 14 deaths total, eight of which were likely suicides. There was a 22-fold increase in suicide rate for males and a 14-fold increase for females compared with age-normalized population rates. Adjusted hazard ratios (95% CI) for premature death were male gender 3.77 (1.11-12.78), nonaffective psychotic disorders 16.3 (3.83-69.34) and the mental illnesses of childhood 6.12 (1.68-22.23). There was a similar pattern for suicide: Male gender, nonaffective psychotic disorders, and the mental illnesses of childhood confer greater risk for subsequent suicide or premature death in this population.
References
Diagnostic and statistical manual of mental disorders (DSM-IV).. Washington, DC: Author (1994).
Aspects of the epidemiology of suicide in England and Wales.. International Journal of Epidemiology, (1976). 5, 133–144
Effects of record linkage errors on registry-based follow-up studies.. Statistics in Medicine, (1997). 16, 2633–2643
Personality disorder, personality traits, impulsive violence and completed suicide in adolescence.. Journal of the American Academy of Child and Adolescent Psychiatry, (1994). 33, 1080–1086
Risk factors for adolescent suicide.. Archives of General Psychiatry, (1988). 45, 581–588
Psychiatric risk factors for adolescent suicide: A case-control study.. Journal of the American Academy of Child and Adolescent Psychiatry, (1993). 32, 521–529
Self-poisoning in Newcastle, 1987-1992.. Medical Journal of Australia, (1995). 162, 190–193
Suicide trends in eight predominantly english-speaking countries 1960-1989.. Social Psychiatry and Psychiatric Epidemiology, (1996). 31, 364–373
Cox's method for follow-up studies.. In Statistical Models in Epidemiology (pp.298-306). Oxford: Oxford University Pres (1993).
Suicide in the 18 years after deliberate self-harm: A prospective study.. British Journal of Psychiatry, (1996). 169, 489–494
Repetition of self-poisoning and subsequent death in adolescents who take overdoses.. British Journal of Psychiatry, (1985). 146, 395–398
Suicide, and other causes of death, following attempted suicide.. British Journal of Psychiatry, (1988). 152, 359–366
Factors associated with suicide after parasuicide in young people.. British Medical Journal, (1993). 306, 1641–1644
Suicide in young people. Study of 174 cases, aged under 25 years, based on coroners' and medical records.. British Journal of Psychiatry, (1999). 175, 271–276
Effects of legislation restricting pack sizes of paracetamol and salicylate on self-poisoning in the United Kingdom: Before and after study.. British Medical Journal, (2001). 322, 1–7
Deliberate self-harm.. Effective Health Care, (1998). 4, 1–12
The Australian national death index: An assessment of accuracy.. Australian and New Zealand Journal of Public Health, (2000). 24, 201–203
Suicide in children and adolescents in England and Wales 1970-1998.. British Journal of Psychiatry, (2001). 178, 469–474
The Australian version of the international classification of diseases, 9th revision, clinical modification.. Sydney: National Coding Center (1996).
Suicidal intent in non-fatal illicit drug overdose.. Addiction, (2000). 95, 85–93
Drug abuse related mortality: a study of teenage addicts over a 20-year period.. Social Psychiatry and Psychiatric Epidemiology, (1999). 34, 437–441
Suicide among drug addicts in the UK.. British Journal of Psychiatry, (1999). 175, 277–282
Relationship of suicide rates to social factors and availability of lethal methods.. British Journal of Psychiatry, (2001). 178, 458–464
Psychiatric diagnosis in child and adolescent suicide.. Archives of General Psychiatry, (1996). 53, 339–348
Psychological autopsy study of completed suicide in children and adolescents.. American Journal of Psychiatry, (1985). 142, 1061–1064
(1999).
Stata Corporation, College Station, TX 77840Outcome of attempted suicide and psychiatric consultation: Risk factors and suicide mortality during a five-year follow-up.. Acta Psychiatrica Scandinavica, (1991). 84, 545–549