Individual- and area-level predictors of self-harm repetition

Johnston, Amy; Cooper, Jayne; Webb, Roger; Kapur, Navneet
November 2006
British Journal of Psychiatry;Nov2006, Vol. 189, p416
Academic Journal
journal article
Background: No ecological studies have examined the relationship between area characteristics, individual characteristics and self-harm repetition.Aims: To investigate the association between area-level factors and incidence and repetition of self-harm, and to identify which area-level factors are independently associated with repetition after adjustment for individual factors.Method: Prospective cohort study using the Manchester Self-Harm database. Adults who were resident in Manchester and presented to an emergency department following self-harm between 1997 and 2002 were included (n = 4743). The main outcome measure was repeat self-harm within 6 months of the index episode.Results: Four individual factors (previous self-harm, previous psychiatric treatment, employment status, marital status) and one area-based factor (proportion of individuals who were of White ethnicity) were independently associated with repetition.Conclusions: Repetition of self-harm may be more strongly related to individual factors than to area characteristics. We need to better understand the processes underlying ecological associations with suicidal behaviour before embarking on area-based interventions.


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