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Multicenter Study
. 2022 Jan;57(1):139-148.
doi: 10.1007/s00127-021-02133-6. Epub 2021 Jul 19.

Self-harm in children 12 years and younger: characteristics and outcomes based on the Multicentre Study of Self-harm in England

Galit Geulayov  1 , Debbie Casey  2 , Liz Bale  2 , Fiona Brand  2   3 , Ellen Townsend  4 , Jennifer Ness  5 , Muzamal Rehman  5 , Keith Waters  5 , Caroline Clements  6 , Bushra Farooq  6 , Nav Kapur  6   7 , Keith Hawton  2   3
Affiliations
Multicenter Study

Self-harm in children 12 years and younger: characteristics and outcomes based on the Multicentre Study of Self-harm in England

Galit Geulayov et al. Soc Psychiatry Psychiatr Epidemiol. 2022 Jan.

Abstract

Background: Very little is known about self-harm in children. We describe the characteristics and outcomes of children under 13 years who presented following self-harm to five hospitals in England.

Methods: We included children under 13 years who presented after self-harm to hospitals in the Multicentre Study of Self-harm in England. Information on patients' characteristics and method of self-harm was available through monitoring of self-harm in the hospitals. Area level of socioeconomic deprivation was based on the English Index of Multiple Deprivation (IMD).

Results: 387 children aged 5-12 years presented to the study hospitals in 2000-2016, 39% of whom were 5-11 years. Boys outnumbered girls 2:1 at 5-10 years. The numbers of boys and girls were similar at age 11, while at 12 years there were 3.8 girls to every boy. The proportion of study children living in neighbourhoods ranked most deprived (43.4%) was twice the national average. 61.5% of children self-poisoned, 50.6% of them by ingesting analgesics. Of children who self-injured, 45.0% self-cut/stabbed, while 28.9% used hanging/asphyxiation. 32% of the children had a repeat hospital presentation for self-harm, 13.5% re-presented within a year.

Conclusions: Gender patterns of self-harm until age 11 years are different to those of adolescents, with a male preponderance, especially in 5-10 years, and hanging/suffocation being more common. The frequent use of self-poisoning in this age group highlights the need for public health messages to encourage safer household storage of medicines. Self-harm in children is strongly associated with socioeconomic deprivation; understanding the mechanisms involved could be important in effective prevention.

Keywords: Adolescents; Children; Methods; Self-harm; Socioeconomic disadvantage.

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Conflict of interest statement

KH and NK declare Grants from the National Institute for Health Research. NK also declares funding from the Health Quality Improvement Partnership and that he chairs the National Institute of Health and Care Excellence (NICE) depression guideline committee and is topic advisor for the new NICE self-harm guideline. All other authors declare no competing interests. KH is a National Institute for Health Research (NIHR) Senior Investigator (Emeritus). The views expressed are those of the authors and not necessarily those of the NHS, the NIHR, or the Department of Health and Social Care.

Figures

Fig. 1
Fig. 1
Number of childrena and presentationsb to hospital following self-harm between 2000 and 2016, by gender and age at hospital attendance. aGender and age at study entry (first presentation to the study hospitals during the study period). bGender and age at presentation to hospital—includes all episodes between 2000–2016 of individuals who were aged under 13 years at first presentation
Fig. 2
Fig. 2
Distribution of children in the study sample according to level of socioeconomic deprivation at first hospital attendance for self-harm compared to the distribution of children in England according to national quintiles: socioeconomic deprivation is based on the English Index of Multiple Deprivation (IMD). aLevel of socioeconomic deprivation is based on the English Index of Multiple Deprivation (IMD) national quintiles (2001–2016)
Fig. 3
Fig. 3
Probability of a repeat self-harm episode in males and females aged 12 years and younger after first presentation to hospital in the study period. Log rank test p = 0.0004
See this image and copyright information in PMC

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