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OBJECTIVES: Alcohol use and misuse are strongly associated with self-harm and increased risk of future self-harm and suicide. The UK general population prevalence of alcohol use, misuse and alcohol-attributable harm has been rising. We have investigated the prevalence of and trends in alcohol use and misuse in self-harm patients and their associations with repeat self-harm and subsequent death. METHODS: We used patient data from the Multicentre Study of Self-Harm in England for 2000-2009 and UK mortality data for patients presenting from 2000 to 2007 who were followed up to the end of 2009. RESULTS: Alcohol involvement in acts of self-harm (58.4%) and alcohol misuse (36.1%) were somewhat higher than found previously in self-harm patients. Alcohol involvement and misuse were most frequent in men, those aged 35-54 years and those from white ethnicities. The frequency of alcohol misuse increased between 2000 and 2009, especially in women. Repetition of self-harm was associated with alcohol involvement in self-harm and particularly with alcohol misuse. Risk of suicide was increased significantly in women misusing alcohol. CONCLUSIONS: Alcohol use and misuse in self-harm patients appears to have increased in recent years, particularly in women. The association of alcohol with greater risk of self-harm repetition and mortality highlights the need for clinicians to investigate alcohol use in self-harm patients. Ready availability of alcohol treatment staff in general hospitals could facilitate appropriate aftercare and the prevention of adverse outcomes.

Original publication

DOI

10.1136/emermed-2013-202753

Type

Journal article

Journal

Emerg Med J

Publication Date

10/2015

Volume

32

Pages

793 - 799

Keywords

alcohol abuse, death/mortality, self harm, suicide, Adolescent, Adult, Age Factors, Aged, Aged, 80 and over, Alcohol Drinking, Alcoholism, Cross-Sectional Studies, England, Female, Humans, Longitudinal Studies, Male, Middle Aged, Prevalence, Risk Factors, Self-Injurious Behavior, Sex Factors, Suicide, Young Adult