Does Clinical Management Improve Outcomes following Self-Harm? Results from the Multicentre Study of Self-Harm in EnglandCitation formats

  • External authors:
  • Matthew Haigh
  • Helen Bergen
  • Keith Hawton
  • Jennifer Ness
  • Keith Waters
  • Jayne Cooper

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Does Clinical Management Improve Outcomes following Self-Harm? Results from the Multicentre Study of Self-Harm in England. / Kapur, Nav; Steeg, Sarah; Webb, Roger; Haigh, Matthew; Bergen, Helen; Hawton, Keith; Ness, Jennifer; Waters, Keith; Cooper, Jayne.

In: PLoS ONE, Vol. 8, No. 8, e70434, 01.08.2013.

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Kapur, Nav ; Steeg, Sarah ; Webb, Roger ; Haigh, Matthew ; Bergen, Helen ; Hawton, Keith ; Ness, Jennifer ; Waters, Keith ; Cooper, Jayne. / Does Clinical Management Improve Outcomes following Self-Harm? Results from the Multicentre Study of Self-Harm in England. In: PLoS ONE. 2013 ; Vol. 8, No. 8.

Bibtex

@article{85506e0019544e529b132602637741f7,
title = "Does Clinical Management Improve Outcomes following Self-Harm? Results from the Multicentre Study of Self-Harm in England",
abstract = "Background:Evidence to guide clinical management of self-harm is sparse, trials have recruited selected samples, and psychological treatments that are suggested in guidelines may not be available in routine practice.Aims:To examine how the management that patients receive in hospital relates to subsequent outcome.Methods:We identified episodes of self-harm presenting to three UK centres (Derby, Manchester, Oxford) over a 10 year period (2000 to 2009). We used established data collection systems to investigate the relationship between four aspects of management (psychosocial assessment, medical admission, psychiatric admission, referral for specialist mental health follow up) and repetition of self-harm within 12 months, adjusted for differences in baseline demographic and clinical characteristics.Results:35,938 individuals presented with self-harm during the study period. In two of the three centres, receiving a psychosocial assessment was associated with a 40{\%} lower risk of repetition, Hazard Ratios (95{\%} CIs): Centre A 0.99 (0.90-1.09); Centre B 0.59 (0.48-0.74); Centre C 0.59 (0.52-0.68). There was little indication that the apparent protective effects were mediated through referral and follow up arrangements. The association between psychosocial assessment and a reduced risk of repetition appeared to be least evident in those from the most deprived areas.Conclusion:These findings add to the growing body of evidence that thorough assessment is central to the management of self-harm, but further work is needed to elucidate the possible mechanisms and explore the effects in different clinical subgroups. {\circledC} 2013 Kapur et al.",
keywords = "Self-Harm cutting overdose parasuicide self-poisoning psychosocial assessment emergency department clinical management A&E",
author = "Nav Kapur and Sarah Steeg and Roger Webb and Matthew Haigh and Helen Bergen and Keith Hawton and Jennifer Ness and Keith Waters and Jayne Cooper",
note = "Funding: The authors acknowledge financial support from the Department of Health under the NHS R&D Programme (DH/DSH2008). KH is a National Institute for Health Research Senior Investigator. The Department of Health and the National Institute for Health Research had no role in study design, the collection, analysis and interpretation of data, the writing of the report, and the decision to submit the paper for publication. The views and opinions expressed within this paper are those of the authors and do not necessarily reflect those of the Department of Health. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.",
year = "2013",
month = "8",
day = "1",
doi = "10.1371/journal.pone.0070434",
language = "English",
volume = "8",
journal = "P L o S One",
issn = "1932-6203",
publisher = "Public Library of Science",
number = "8",

}

RIS

TY - JOUR

T1 - Does Clinical Management Improve Outcomes following Self-Harm? Results from the Multicentre Study of Self-Harm in England

AU - Kapur, Nav

AU - Steeg, Sarah

AU - Webb, Roger

AU - Haigh, Matthew

AU - Bergen, Helen

AU - Hawton, Keith

AU - Ness, Jennifer

AU - Waters, Keith

AU - Cooper, Jayne

N1 - Funding: The authors acknowledge financial support from the Department of Health under the NHS R&D Programme (DH/DSH2008). KH is a National Institute for Health Research Senior Investigator. The Department of Health and the National Institute for Health Research had no role in study design, the collection, analysis and interpretation of data, the writing of the report, and the decision to submit the paper for publication. The views and opinions expressed within this paper are those of the authors and do not necessarily reflect those of the Department of Health. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.

PY - 2013/8/1

Y1 - 2013/8/1

N2 - Background:Evidence to guide clinical management of self-harm is sparse, trials have recruited selected samples, and psychological treatments that are suggested in guidelines may not be available in routine practice.Aims:To examine how the management that patients receive in hospital relates to subsequent outcome.Methods:We identified episodes of self-harm presenting to three UK centres (Derby, Manchester, Oxford) over a 10 year period (2000 to 2009). We used established data collection systems to investigate the relationship between four aspects of management (psychosocial assessment, medical admission, psychiatric admission, referral for specialist mental health follow up) and repetition of self-harm within 12 months, adjusted for differences in baseline demographic and clinical characteristics.Results:35,938 individuals presented with self-harm during the study period. In two of the three centres, receiving a psychosocial assessment was associated with a 40% lower risk of repetition, Hazard Ratios (95% CIs): Centre A 0.99 (0.90-1.09); Centre B 0.59 (0.48-0.74); Centre C 0.59 (0.52-0.68). There was little indication that the apparent protective effects were mediated through referral and follow up arrangements. The association between psychosocial assessment and a reduced risk of repetition appeared to be least evident in those from the most deprived areas.Conclusion:These findings add to the growing body of evidence that thorough assessment is central to the management of self-harm, but further work is needed to elucidate the possible mechanisms and explore the effects in different clinical subgroups. © 2013 Kapur et al.

AB - Background:Evidence to guide clinical management of self-harm is sparse, trials have recruited selected samples, and psychological treatments that are suggested in guidelines may not be available in routine practice.Aims:To examine how the management that patients receive in hospital relates to subsequent outcome.Methods:We identified episodes of self-harm presenting to three UK centres (Derby, Manchester, Oxford) over a 10 year period (2000 to 2009). We used established data collection systems to investigate the relationship between four aspects of management (psychosocial assessment, medical admission, psychiatric admission, referral for specialist mental health follow up) and repetition of self-harm within 12 months, adjusted for differences in baseline demographic and clinical characteristics.Results:35,938 individuals presented with self-harm during the study period. In two of the three centres, receiving a psychosocial assessment was associated with a 40% lower risk of repetition, Hazard Ratios (95% CIs): Centre A 0.99 (0.90-1.09); Centre B 0.59 (0.48-0.74); Centre C 0.59 (0.52-0.68). There was little indication that the apparent protective effects were mediated through referral and follow up arrangements. The association between psychosocial assessment and a reduced risk of repetition appeared to be least evident in those from the most deprived areas.Conclusion:These findings add to the growing body of evidence that thorough assessment is central to the management of self-harm, but further work is needed to elucidate the possible mechanisms and explore the effects in different clinical subgroups. © 2013 Kapur et al.

KW - Self-Harm cutting overdose parasuicide self-poisoning psychosocial assessment emergency department clinical management A&E

U2 - 10.1371/journal.pone.0070434

DO - 10.1371/journal.pone.0070434

M3 - Article

VL - 8

JO - P L o S One

JF - P L o S One

SN - 1932-6203

IS - 8

M1 - e70434

ER -