K Hawton

..Self-harm (intentional self-poisoning and self-injury) in children and adolescents is often repeated and is associated with increased risk of future suicide. We have investigated factors associated with these outcomes...

..Self-help resources are an important means of supporting people bereaved by suicide. These require careful evaluation...

..National guidance on provision of psychosocial assessment in all cases of self-harm requires further implementation...

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..The identification of successful prevention initiatives aimed at young people and those at especially high risk, and the establishment of effective treatments for those who self-harm, are paramount needs...

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..One approach to reducing access to pesticides is for households to store pesticides in lockable "safe-storage" containers. However, before this approach can be promoted, evidence is required on its effectiveness and safety...

..This study aimed to evaluate the impact of the withdrawal of distalgesic in terms of intentional drug overdose (IDO) presentations to hospital emergency departments (EDs) nationally...

..The authors compared the characteristics of suicide attempters with and without comorbid psychiatric and personality disorders to identify factors that explain the high suicide risk associated with psychiatric comorbidity...

..Deliberate self-harm (DSH) may be associated with increased risk of death from a variety of causes, not just suicide...

..Our aim was to determine whether this resulted in smaller overdoses of paracetamol in Ireland compared with the UK...

..Contagion may be an important factor in DSH by adolescents, especially in girls who cut themselves. These findings are relevant to the design of prevention and treatment programmes...

..National data are required to examine this issue. It is also important to investigate the possible contribution of psychiatric disorder and access to specific suicide methods...

..Deliberate self-harm (DSH) is the strongest risk factor for future suicide. Up-to-date information on the extent of risk is lacking...

..Deliberate self-harm (DSH) is a major healthcare problem in adolescents. Identification of targets for prevention and treatment requires ongoing monitoring of trends and characteristics of those involved...

..Prescriptions of co-proxamol were reduced in the 3-year withdrawal phase (2005 to 2007) following the CSM announcement...

..To determine whether rates of suicide and self-harm in university students differ from those in other young people...

..These findings illustrate how the nature of self-harming behavior may vary in intention across the life cycle and between the genders, and provide a basis for further comparative work of this kind...

..Safer storage of pesticides may be one means of prevention. We have conducted a study to assess the acceptability and use of lockable boxes for storing pesticides in rural Sri Lanka...

..Little is known about self-harm in the armed forces...

..To examine in detail a series of coproxamol overdose deaths in order to provide information that will assist in the development of strategies to prevent such fatalities...

..To assess the effect of the UK Committee on Safety of Medicines' announcement in January 2005 of withdrawal of co-proxamol on analgesic prescribing and poisoning mortality...

..To evaluate the long term effect of legislation limiting the size of packs of analgesics sold over the counter...

..Doctors are at higher risk of suicide than many other occupational groups. This study was conducted to investigate factors associated with suicide in doctors...

..Self-poisoning is a common method of suicide and often involves ingestion of antidepressants. Information on the relative toxicity of antidepressants is therefore extremely important...

..To investigate the characteristics of young deliberate self-harm (DSH) patients and determine outcome in terms of mortality and risk factors for suicide...

..To examine the incidence of suicides due to co-proxamol compared with tricyclic antidepressants and paracetamol, and to compare fatality rates for self poisonings with these drugs...

..The death of the Princess of Wales in 1997 was followed by widespread public mourning. Such major events may influence suicidal behaviour...

..Reporting a ratio across all ages may conceal important variations in the gender ratio across the life cycle...

..Relatively little information is available about the characteristics and long-term outcome of children and adolescents aged under 15 years who present to general hospitals because of deliberate self-harm (DSH)...

..Little information is available about older deliberate self-harm (DSH) patients and their outcome...

..They represent an important subgroup of those who self-harm, who require especially careful assessment and follow-up...

..Finally we consider the potential uses of the data for both clinical and research purposes, including evaluation of national suicide prevention initiatives...

..Multicentre monitoring of self-harm has been established as a result of the National Suicide Prevention Strategy for England...

..In two studies of DSH patients in Edinburgh the extent of provision of psychiatric aftercare was inversely related to social class. These findings have not been investigated in other areas...

..Degree of suicidal intent may also influence choice of method of self-poisoning...

..Given the paucity of evidence for superior therapeutic efficacy of co-proxamol over other less toxic analgesics, there are good reasons to question whether it should continue to be prescribed...

..In assessing suicide risk a history of DSH and the presence of comorbid psychiatric and personality disorders are particularly important...

..CONCLUSION: Legislation restricting pack sizes of paracetamol and salicylates in the United Kingdom has had substantial beneficial effects on mortality and morbidity associated with self poisoning using these drugs...

..Suicide rates in young males in the UK have risen markedly in recent years...

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..To determine whether a serious paracetamol overdose in the medical television drama Casualty altered the incidence and nature of general hospital presentations for deliberate self poisoning...

..Deliberate self-harm (DSH; intentional self-poisoning or self-injury) is a major problem among young people and has been identified as one of the key mental health problems affecting students...

..The aim of this study was to investigate the long-term mortality, morbidity and quality of life of such patients...

..In the management of adolescents who have harmed themselves, careful assessment of depression and appropriate management of those who are depressed is essential...

..Availability of method may be a factor contributing to the relatively high suicide rate of doctors. This fact might influence clinical management of doctors who are known to be depressed or suicidal...

..CONCLUSIONS: Reducing socio-economic deprivation and its associated problems may be an important strategy in the prevention of suicidal behaviour, especially in young men...

..To investigate the suicide risk of doctors in England and Wales, according to gender, seniority and specialty...

..CONCLUSIONS: The management of women presenting to hospital after self-poisoning should include assessment of abuse experiences, and instigation of appropriate treatment in those with significant sequelae of abuse...

..They have implications for services for DSH patients and may have an impact on future patterns of suicidal behaviour...

..The prevention of suicide in the young clearly requires multiple strategies...

..CONCLUSION: Personality factors, as well as depression, are important risk factors for suicide in older people...

..The aims of this study were to examine life problems according to age, gender, suicidal intent and other patient characteristics in DSH patients...

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..Following legislation in 1998 to limit pack sizes, beneficial effects on paracetamol-related mortality and morbidity were reported in England. However, there are still over 100 deaths a year and evidence of breaches of sales guidelines...

..Although risk factors for suicide following self-harm are often investigated, rarely have those for accidents been studied. Our aim was to compare risk factors for suicide and accidents...

..The views of health professionals played a relatively small role. There is potentially a considerable opportunity to help patients arrive at a wider and more enabling explanation of their illness when they first present to primary care...

..Approaches to suicide prevention include those targeting high-risk groups and population strategies. There are, however, many challenges to large-scale prevention, especially in developing countries...

..SIB and eating disorder symptoms may provide a means whereby patients can deal with each factor simultaneously. The clinical implications of the findings are discussed...

..Hospital services need to be organised such that DSH patients managed in A&E departments can receive an assessment of psychosocial problems and risk...

..The prognostic value of self-esteem warrants further investigation and appears to have therapeutic implications...

..I also discuss the future potential for this research approach and further questions that might be addressed by it...

..The changes have had significant positive initial benefits on the mortality and morbidity associated with self-poisoning with analgesics...

..Clinicians need to assess suicidal ideation and risk of self-harm when prescribing for this population...

..This study reinforces recent findings that seasonal variation in suicide appears to be diminishing, even in an occupational group where this might be expected...

..We have investigated how patient characteristics and clinical management of DSH episodes vary according to hour and day of presentation...

..There is preliminary evidence to suggest that veterinary surgeons are a group at risk...

..It is desirable that this finding is confirmed in a large trial, which will also allow adequate testing of the impact of this treatment on repetition of DSH...

..3% of patients were satisfied with the follow-up consultations. CONCLUSIONS: The major role of the GP in the prevention of suicidal behaviour is in the detection and treatment of depression, and in the aftercare of DSH patients...

..In particular, several studies have reported an association with variants in the tryptophan hydroxylase (TPH) gene...

..The possible reasons for this are considered, particularly in the context of relative stability of suicide rates in young females...

..Previous UK studies have reported much lower rates of psychiatric and personality disorder in those who attempt suicide than in those who die by suicide...

..It also indicates that the treatment needs of those who deliberately cut themselves are likely to differ from those of self-poisoners...

..This review was undertaken to assess the effectiveness of management strategies for sexual dysfunction caused by antidepressant medication...

..Methodological considerations are highlighted and implications of the findings for clinicians and other professionals concerned with prevention of suicidal behavior by adolescents are discussed...

..Internet gamblers appear to be heterogeneous but composed of several subgroups, differing markedly on both demographic and clinical characteristics...

..To examine factors associated with suicide in prisoners...

..Suicide risk is greatly increased in schizophrenia. Detection of those at risk is clinically important...

..CONCLUSIONS: Repetition of DSH is associated with an increased risk of suicide in males and females. Repetition may be a better indicator of risk in females, especially young females...

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..Although suicide rates among prisoners are high and vary between countries, it is uncertain whether this reflects the importation of risk from the general population or is associated with incarceration rates...

..These findings have implications for targeting prevention campaigns through the media and educational initiatives...

..The authors sought to determine the efficacy and acceptability of lithium for relapse prevention in bipolar disorder...

..There are national guidelines for prescribing antidepressants. There have been few investigations of how non-fatal self-poisoning with antidepressants varies in relation to prescribing and to patient characteristics...

..To determine the prevalence of deliberate self harm in adolescents and the factors associated with it...

..However it is not clear which clinical variables are associated with low memory specificity in this group, or whether low specificity is particularly associated with recent DSH...

..It is the commonest cause of death in men under the age of 35 years. This article reviews the epidemiology, causal factors and prevention of suicide, and also briefly discusses the role of audit in this area...

..The results provide preliminary evidence to suggest the presence of a suicidal process in women, in which the impact of negative life events on suicide intent diminishes across episodes...

..Self-harm is increasingly common in many countries, is often repeated and may have other negative outcomes...

..To determine the psychological characteristics and nature of life problems, including physical illness, in people 60 years and over dying through suicide in the absence of psychiatric disorder...

..To investigate whether there are differences between the characteristics of deliberate self-harm (DSH) patients with and without a family history of suicidal behaviour...

..While clinical guidelines suggest good practice for the short-term hospital management of DSH, there remains considerable variability in the way that services are provided...

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..They are of theoretical interest, and have important clinical implications regarding identification of patient groups especially susceptible to DSH at New Year...

..The role of physical illness and life problems in contributing to suicide in older people is potentially important with regard to suicide prevention...

..CONCLUSIONS: The measurement of suicidal intent in the assessment of self-harm patients is beneficial for the evaluation of future suicide risk. A shortened measuring scale might be useful in clinical practice...

..g., low self-esteem) may play a mediating role in the relationship between abuse and suicidal phenomena. CONCLUSIONS: There is a clear link between abuse and suicidal phenomena occurring during childhood and adolescence...

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..CONCLUSIONS: The SIS cannot predict which individual patients will ultimately die by suicide. Nonetheless, information regarding suicidal intent is valuable in the clinical risk assessment and management of DSH patients...