Life problems and deliberate self-harm: associations with gender, age, suicidal intent and psychiatric and personality disorder.

BACKGROUND: Deliberate self-harm (DSH) may occur in response to negative life events and life problems. High suicidal intent may be a risk factor for subsequent suicide but little is known about how life problems and suicidal intent are related. The aims of this study were to examine life problems according to age, gender, suicidal intent and other patient characteristics in DSH patients.

METHODS: Data from the Oxford Monitoring System for Attempted Suicide were used to investigate life problems contributing to DSH and their relationship to patient variables including Suicide Intent Scale (SIS) scores in DSH patients presenting to the general hospital in Oxford between 1993 and 2000. Of 4391 persons included in the study 80.6% reported multiple life problems, the most common being in the relationship with spouse or partner. The nature of the most frequent problems changed over the life-span and there were gender differences. Females, but not males, with high suicidal intent had more problems than those with low intent and for females with no past history of DSH there was a weak positive correlation between the number of life problems and total SIS score. Patients with high intent more frequently experienced psychiatric and social isolation problems than those with low intent. Females with high intent more frequently reported bereavement or loss and eating problems.

LIMITATIONS: The study population was not entirely representative of all DSH patients presenting to hospital.

CONCLUSIONS: Most DSH patients have multiple life problems and the type of problems may be associated with varying degrees of suicidal intent. Patients should be offered interventions individually tailored according to their specific problems.