English summary: ATTENDANCES DUE TO DELIBERATE SELF-HARM AND PSYCHIATRIC CONSULTATION RATE IN THE EMERGENCY DEPARTMENT AT A REGIONAL HOSPITAL - A PROSPECTIVE STUDY
Background There is little recent information on the epidemiology of deliberate self-harm or on the psychiatric consultation rate in these cases. Regional monitoring of self-harm and attempted suicides is insufficient. At the Centre of Injury and Violence Prevention located in Kouvola, Finland, self-inflicted injuries and related factors are regularly monitored. The data will be used for injury prevention.
Methods Data on patients attending the emergency department (ED) at Kuusankoski Regional hospital (since January 1st 2011 North Kymi Hospital) due to deliberate self-harm were gathered prospectively for two years. Breath alcohol concentration was measured on admission.
Results A total of 272 cases, 55% of which occurred in women. The total number of patients was 210. The rate of repetitions in the total data was 16%. 71% of men and 61% of women were under the influence of alcohol at the time of attendance. The typical patient was a female aged 15-24 or 40-44 years, or a male aged 20-29 years, who attended the ED on a weekend night and was under the influence of alcohol.
Two out of three cases (184/272) involved intoxication and most (66%) were alcohol-related. However, self-cutting was frequent among patients under 20 years of age (15/37, 41%). A psychiatric diagnosis was lacking in two out of three patients. Psychiatric consultation took place in half of the intoxication cases and in one third of the self-cutting cases.
Conclusions Young and middle-aged women and young male adults were at highest risk of deliberate self-harm. Alcohol was strongly associated with self-harm. Psychiatric evaluation and psychiatric consultation varied considerably.
Regular monitoring of deliberate self-harm is important in order to follow up trends in mental health and alcohol abuse in the population. The data should be used for prevention and for planning adequate psychiatric consultation and mental health services.
