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Deliberate self-harm in children and adolescents: an 11-year case note study

Published online by Cambridge University Press:  13 June 2014

Fiona McNicholas ,
John Fagan ,
Brid Tobin ,
Mairin Doherty  and
Neil Adamson
Fiona McNicholas
Affiliation:
Department of Child and Adolescent Psychiatry, Our Lady's Children's Hospital, Crumlin, Dublin 12, Ireland, Lucena Clinic, Rathgar and University College, Dublin
John Fagan
Affiliation:
Child and Adolescent Psychiatry, Lucena Clinic, Wicklow, Ireland
Brid Tobin
Affiliation:
Lucena Clinic, Rathgar and University College, Dublin, Ireland
Mairin Doherty
Affiliation:
Department of Child Psychiatry, Our Lady's Hospital for Sick Children, Crumlin, Dublin 12, Ireland
Neil Adamson
Affiliation:
Department of Child Psychiatry, Our Lady's Hospital for Sick Children, Crumlin, Dublin 12, Ireland
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Abstract

Objective: To retrospectively examine the case-notes of all children and adolescents admitted with deliberate self-harm (DSH) or suicidal ideation during the study period 1993-2003. The study aimed to identify underlying reasons why children and adolescents engage in DSH, and to identify common psychiatric, psychosocial and familial factors which may predispose or contribute to an individual's engagement in such behaviour.

Method: All children presenting to the hospital with DSH or suicidal ideation were identified and data collected from their case notes. A study specific questionnaire was designed to collect demographic details, details on clinical presentation, past attempts, comorbid psychiatry disorders, family history and family circumstances. Information was also recorded on hospital stay and discharge planning.

Results: During the 11-year period, 231 children presented with suicidal ideation or behaviour. The mean age was 12.85 with an age range from 6-17 years, with a female:male ratio of 2.5:1. Overdose was the most common method (81.2%) and paracetamol most commonly the drug of choice. More than half of the group (55.7%) expressed a wish to die. More than half (51.8%) had expressed suicidal ideation in the past, 31% had made a previous attempt, and 11.7% had been previously admitted. Of the children 8% presented with suicidal behaviour more than once over the study period. There was a family history of completed suicide in 6.6%.

Conclusion: Deliberate self-harm in young people is a significant public health problem in Ireland. During the period of this study, rates have continued to increase. There is an urgent need for national bodies such as the National Suicide Review Group to extend their focus to include those under age 18 and for services to be developed that might reduce DSH behaviours. More research is needed in the area of childhood suicidal behaviour.

Keywords

Deliberate self-harm (DSH)Suicidal ideation
Type
Original papers
Information
Irish Journal of Psychological Medicine , Volume 28 , Issue 4 , December 2011 , pp. 191 - 195
Copyright
Copyright © Cambridge University Press 2011

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