Background stressors and deliberate self-harm: Prospective case note study in southern Ireland

Aims and method: In this study we aimed to identify negative life events, especially those associated with repetition, in the background histories of patients in a 2-year prospective monitoring study of hospital-treated deliberate self-harm (DSH).Thematic analysis of the narratives recorded during assessment was used to produce general categories of life events. Results: In 3031 DSH episodes (n=2287 individuals), women reported more life events than men. Family and inter-personal problems were most commonly reported. Reporting a dysfunctional family of origin, a history of sexual abuse and the imprisonment of self or other were associated with repetition retrospectively and prospectively. Clinical implications: The background history of patients who harm themselves should be explored routinely on assessment in order to help establish risk of repetition and to determine appropriate follow-up.