Abstract

BackgroundVery little is known about self-harm in children. We describe the characteristics and outcomes of children under 13 years who presented following self-harm to five hospitals in England.MethodsWe included children under 13 years who presented after self-harm to hospitals in the Multicentre Study of Self-harm in England. Information on patients’ characteristics and method of self-harm was available through monitoring of self-harm in the hospitals. Area level of socioeconomic deprivation was based on the English Index of Multiple Deprivation (IMD).Results387 children aged 5–12 years presented to the study hospitals in 2000–2016, 39% of whom were 5–11 years. Boys outnumbered girls 2:1 at 5–10 years. The numbers of boys and girls were similar at age 11, while at 12 years there were 3.8 girls to every boy. The proportion of study children living in neighbourhoods ranked most deprived (43.4%) was twice the national average. 61.5% of children self-poisoned, 50.6% of them by ingesting analgesics. Of children who self-injured, 45.0% self-cut/stabbed, while 28.9% used hanging/asphyxiation. 32% of the children had a repeat hospital presentation for self-harm, 13.5% re-presented within a year.ConclusionsGender patterns of self-harm until age 11 years are different to those of adolescents, with a male preponderance, especially in 5–10 years, and hanging/suffocation being more common. The frequent use of self-poisoning in this age group highlights the need for public health messages to encourage safer household storage of medicines. Self-harm in children is strongly associated with socioeconomic deprivation; understanding the mechanisms involved could be important in effective prevention.

Highlights

  • Very little is known about self-harm in children

  • Several decades ago Pfeffer and colleagues investigated self-harm and suicidal ideation in ‘latency age’ (6–12-year old) children admitted to psychiatric wards in the USA, highlighting the fact that the prevalence of suicidal behaviours was higher in boys; 37/50 (74%) of boys compared to 5/8 (62%) of girls showed some form of suicidal behaviour

  • This gender pattern is in marked contrast to that generally found in young adolescents who present to general hospital following self-harm, in which girls greatly outnumber boys [3]

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Summary

Introduction

We describe the characteristics and outcomes of children under 13 years who presented following self-harm to five hospitals in England. This pattern was subsequently replicated in 6–12year olds receiving out-patient treatment for a psychiatric condition [2] This gender pattern is in marked contrast to that generally found in young adolescents who present to general hospital following self-harm, in which girls greatly outnumber boys [3]. Studart-Botto et al [5] described self-injurious behaviour in a large population of Brazilian children under 10 years who were registered in hospital systems between 1996 and 2018. In their 5–9-year-old children, boys outnumbered girls

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