Self-Harm and High Suicide Risk: Age Makes a Difference

Self-harm is the most prominent risk factor for completed suicide. In a 10-year, prospective cohort study, researchers examined patient characteristics and subsequent risk for suicide in 374 individuals age 55 or older and 1937 individuals age 35 to 54 (mean ages, 66 and 42, respectively) presenting to the emergency department with a first episode of self-harm.

Of the 1424 patients receiving mental health assessments, 68% were given psychiatric diagnoses. At baseline, the older group had more hopelessness and higher suicidal intent than the middle-aged group. In follow-up, the older group had lower rates of repeated attempts (12% vs. 15%) but these were more often fatal (14% vs. 3%). In a regression analysis, the most important predictor of …