Population-based study of medically treated self-inflicted injuries.

OBJECTIVE Self-inflicted injury is commonly seen in emergency departments (EDs). It may be a pre-cursor to death by suicide. The objective of this study was to examine the epidemiology of self-inflicted injury presentations to EDs in the province of Alberta. METHODS Self-inflicted injury records for the 3 fiscal years 1998/99 to 2000/01 were accessed from the Ambulatory Care Classification System, a database that captures all ED encounters in the province of Alberta. Available data for each case included demographic details, location and time of visit, diagnoses and procedures. RESULTS There were 22 396 self-inflicted injury presentations to Alberta EDs during the study period. Self-inflicted injury rates were higher in females, younger patients, those on social services and those with Aboriginal treaty status. There were higher rates of return visits in the year following the self-inflicted injury than in other patient groups. Data showed regional variation. Trends could be seen in the timing of self-inflicted injury presentations by hour of day, day of week, and month of year. CONCLUSIONS Self-inflicted injury is common, with particularly high rates demonstrated among marginalized populations. This study provides comprehensive data on those who present with self-inflicted injuries, and can be used to guide further treatment, research and evaluation for this population.

[1]  A. Roy,et al.  Suicide attempts in the Epidemiologic Catchment Area Study. , 1988, The Yale journal of biology and medicine.

[2]  J. Lönnqvist,et al.  Attempted suicide in Europe: rates, trend.S and sociodemographic characteristics of suicide attempters during the period 1989–1992. Results of the WHO/EURO Multicentre Study on Parasuicide , 1996, Acta psychiatrica Scandinavica.

[3]  R. Goldney A global view of suicidal behaviour. , 2002, Emergency medicine.

[4]  Eduardo García España Terminology , 1973, Hybrid Nuclear Energy Systems.

[5]  R. Bland,et al.  SUICIDE ATTEMPTS AND PSYCHIATRIC DISORDERS IN EDMONTON , 1988, Acta psychiatrica Scandinavica. Supplementum.

[6]  E. Rhoades The health status of American Indian and Alaska native males. , 2003, American journal of public health.

[7]  P. Links,et al.  Do hospital E-codes consistently capture suicidal behaviour? , 2002, Chronic diseases in Canada.

[8]  F. Trovato Canadian Indian mortality during the 1980s , 2000, Social biology.

[9]  R. Bland,et al.  Social Dysfunction and Mental Illness in a Community Sample , 1995, Canadian journal of psychiatry. Revue canadienne de psychiatrie.

[10]  J Lellouch,et al.  Prevalence of suicide ideation and suicide attempts in nine countries , 1999, Psychological Medicine.

[11]  M. Goldacre,et al.  Reliability of routine hospital data on poisoning as measures of deliberate self poisoning in adolescents. , 1990, Journal of epidemiology and community health.

[12]  C. Stark,et al.  Thirteen-year follow-up of deliberate self-harm, using linked data , 1998, British Journal of Psychiatry.

[13]  S. Welch,et al.  A review of the literature on the epidemiology of parasuicide in the general population. , 2001, Psychiatric services.

[14]  T. K. Young,et al.  Suicide among Manitoba's aboriginal people, 1988 to 1994. , 1997, CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne.

[15]  J. Lonnqvist,et al.  Parasiticide in Europe: the WHO/EURO multicentre study on parasuicide. I. Introduction and preliminary analysis for 1989 , 1992, Acta psychiatrica Scandinavica.

[16]  J. Lönnqvist,et al.  Mental disorders and comorbidity in attempted suicide , 1996, Acta psychiatrica Scandinavica.

[17]  J. Lonnqvist,et al.  Suicides hidden among undetermined deaths , 1998, Acta psychiatrica Scandinavica.

[18]  A. Preti,et al.  The influence of seasonal change on suicidal behaviour in Italy. , 1997, Journal of affective disorders.

[19]  G. Masterton Monthly and Seasonal Variation in Parasuicide , 1991, British Journal of Psychiatry.

[20]  D. Voaklander,et al.  Utilization of the emergency department after self-inflicted injury. , 2004, Academic emergency medicine : official journal of the Society for Academic Emergency Medicine.

[21]  E. Kua,et al.  Temporal Variation in Parasuicide among Singaporean Chinese , 1998, The Australian and New Zealand journal of psychiatry.

[22]  S. Sidney,et al.  Hospitalization for suicide attempt and completed suicide: epidemiological features in a managed care population , 2000, Social Psychiatry and Psychiatric Epidemiology.

[23]  W. Cleveland,et al.  Locally Weighted Regression: An Approach to Regression Analysis by Local Fitting , 1988 .

[24]  C. Haring,et al.  Temporal fluctuations and seasonality in attempted suicide in europe: Findings from the who/euro multicentre study on parasuicide , 1999 .

[25]  R. Bland,et al.  A multivariate study of predictors of repeat parasuicide , 2004, Acta psychiatrica Scandinavica.

[26]  B. Barraclough,et al.  Excess mortality of mental disorder , 1998, British Journal of Psychiatry.

[27]  R. Farmer,et al.  The Limitations of Official Suicide Statistics , 1995, British Journal of Psychiatry.

[28]  T R Miller,et al.  Suicide acts in 8 states: incidence and case fatality rates by demographics and method. , 2000, American journal of public health.

[29]  J. Lönnqvist,et al.  Excess mortality of suicide attempters , 2001, Social Psychiatry and Psychiatric Epidemiology.

[30]  C. Haring,et al.  Temporal fluctuations and seasonality in attempted suicide in Europe , 1999 .

[31]  K. Hawton,et al.  Suicide, and Other Causes of Death, Following Attempted Suicide , 1988, British Journal of Psychiatry.

[32]  C. Jennison,et al.  Seasonal and Weather Factors in Parasuicide , 1994, British Journal of Psychiatry.

[33]  M. Mahoney,et al.  Health status of American Indians/Alaska Natives: general patterns of mortality. , 1998, Family medicine.

[34]  P. O'Carroll,et al.  Attempted suicide among young adults: progress toward a meaningful estimate of prevalence. , 1992, The American journal of psychiatry.