Self-harm presentation across healthcare settings by sex in young people: an e-cohort study using routinely collected linked healthcare data in Wales, UK

被引:27
|
作者
Marchant, Amanda [1 ]
Turner, Samantha [1 ]
Balbuena, Lloyd [2 ]
Peters, Evyn [2 ]
Williams, Dave [3 ]
Lloyd, Keith [1 ]
Lyons, Ronan [1 ]
John, Ann [1 ]
机构
[1] Swansea Univ, Med Sch, Swansea SA2 8PP, W Glam, Wales
[2] Univ Saskatchewan, Dept Psychiat, Saskatoon, SK, Canada
[3] Aneurin Bevan Hlth Board, Child & Adolescent Psychiat, Newport, Gwent, Wales
基金
英国工程与自然科学研究理事会; 英国惠康基金; 英国医学研究理事会; 英国经济与社会研究理事会;
关键词
RECENT TRENDS; ADOLESCENTS; SUICIDE; MANAGEMENT; CHILDREN; OXFORD;
D O I
10.1136/archdischild-2019-317248
中图分类号
R72 [儿科学];
学科分类号
100202 ;
摘要
Background This study used individual-level linked data across general practice, emergency departments (EDs), outpatients and hospital admissions to examine contacts across settings and time by sex for self-harm in individuals aged 10-24 years old in Wales, UK. Methods A whole population-based e-cohort study of routinely collected healthcare data was conducted. Rates of self-harm across settings over time by sex were examined. Individuals were categorised based on the service(s) to which they presented. Results A total of 937 697 individuals aged 10-24 years contributed 5 369 794 person years of data from 1 January 2003 to 30 September 2015. Self-harm incidence was highest in primary care but remained stable over time (incident rate ratio (IRR)=1.0; 95% CI 0.9 to 1.1). Incidence of ED attendance increased over time (IRR=1.3; 95% CI 1.2 to 1.5) as did hospital admissions (IRR=1.4; 95% CI 1.1 to 1.6). Incidence in the 15-19 years age group was the highest across all settings. The largest increases were seen in the youngest age group. There were increases in ED attendances for both sexes; however, females are more likely than males to be admitted following this. This was most evident in individuals 10-15 years old, where 76% of females were admitted compared with just 49% of males. The majority of associated outpatient appointments were under a mental health specialty. Conclusions This is the first study to compare self-harm in people aged 10-24 years across primary care, EDs and hospital settings in the UK. The high rates of self-harm in primary care and for young men in EDs highlight these as important settings for intervention.
引用
收藏
页码:347 / 354
页数:8
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