• Rachael Lilley, David Owens, Judith Horrocks, Allan House, Rachael Noble, Helen Bergen, Keith Hawton, Deborah Casey, Sue Simkin, Elizabeth Murphy, Jayne Cooper, and Navneet Kapur.
• Academic Unit of Psychiatry and Behavioural Sciences, Leeds Institute of Health Sciences, University of Leeds, Charles Thackrah Building, 101 Clarendon Road, Woodhouse, Leeds LS2 9LJ.
• Br J Psychiatry. 2008 Jun 1; 192 (6): 440-5.

BackgroundQuantitative research about self-harm largely deals with self-poisoning, despite the high incidence of self-injury.AimsWe compared patterns of hospital care and repetition associated with self-poisoning and self-injury.MethodDemographic and clinical data were collected in a multicentre, prospective cohort study, involving 10,498 consecutive episodes of self-harm at six English teaching hospitals.ResultsCompared with those who self-poisoned, people who cut themselves were more likely to have self-harmed previously and to have received support from mental health services, but they were far less likely to be admitted to the general hospital or receive a psychosocial assessment. Although only 17% of people repeated self-harm during the 18 months of study, survival analysis that takes account of all episodes revealed a repetition rate of 33% in the year following an episode: 47% after episodes of self-cutting and 31% after self-poisoning (P<0.001). Of those who repeated, a third switched method of self-harm.ConclusionsHospital services offer less to people who have cut themselves, although they are far more likely to repeat, than to those who have self-poisoned. Attendance at hospital should result in psychosocial assessment of needs regardless of method of self-harm.

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