Fifty cases of general hospital parasuicide

Abstract

Objectives. This study investigates 50 cases of parasuicide (defined as any act of deliberate self-harm irrespective of intention) admitted via an accident and emergency department of a general hospital and identifies differences between parasuicide sub-types. Design. A cross-sectional design is employed. Methods. Fifty individuals were interviewed the morning following a parasuicidal episode. Index parasuicides (N = 24) were compared with repeaters (N = 26). Those who verbalized their desire to die (N = 21) were compared with those who did not want to die (N = 16) and those who were ambivalent (N = 13). The interview schedule measured five risk factor domains including self-report of mental and physical health, perceptions of control, isolation and stressors. Results. The prevalence of previously reported risk factors was replicated. Those who repeatedly attempted suicide tended to view their actions as more aggressive and were less relieved to be alive than those who attempted suicide for the first time. They also tended to be more angry at being alive and recognized the fatal consequences of their acts. Those who verbalized a wish to die differed from those who did not, and from those who were ambivalent, in terms of perceived aggressiveness of their actions, relief at being alive, anger and perceived risk.  Conclusions. Self-report measures can distinguish repeaters from first-time parasuicides. These findings could be integrated into existing risk assessment procedures and improve their effectiveness.