Skip to main content
Search
Search
    Quick Search anywhere
    Quick search in Citations
Advanced Search
Skip main navigationClose Drawer MenuOpen Drawer Menu
Previous article
Next article
Open AccessResearch Trends

Incidence Rates of Deliberate Self-Harm in Denmark 1994–2011

A Nationwide Register Study

Published Online:June 09, 2016https://doi.org/10.1027/0227-5910/a000391

Abstract

Abstract.Background: The validity and reliability of suicide statistics have been questioned and few nationwide studies of deliberate self-harm have been presented. Aim: To calculate rates of deliberate self-harm in Denmark in order to investigate trends and assess the reliability of hospital records. Method: A register study based on all individuals recorded with an episode of deliberate self-harm or probable deliberate self-harm in nationwide registers during 1994–2011. Results: A substantial difference in the rates of deliberate self-harm and probable deliberate self-harm was noted for both genders. The average incidence rate of deliberate self-harm for women and men was 130.7 (95% CI = 129.6–131.8) per 100,000 and 86.9 (95% CI = 86.0–87.8) per 100,000, respectively. The rates of deliberate self-harm for women increased from 137.6 (95% CI = 132.9–142.3) per 100,000 in 1994 to 152.7 (95% CI = 147.8–157.5) in 2011. For a subgroup of younger women aged 15–24 years, an almost threefold increase was observed, IRR = 2.5 (95% CI = 2.4–2.7). The most frequently used method was self-poisoning. Conclusion: The rates of deliberate self-harm and probable deliberate self-harm differed significantly. An increased incidence of deliberate self-harm among young Danish women was observed, despite detection bias. An improved registration procedure of suicidal behavior is needed.

References

  • Alander, S. W., Dowd, M. D., Bratton, S. L., & Kearns, G. L. (2000). Pediatric acetaminophen overdose: Risk factors associated with hepatocellular injury. Archives of Pediatrics & Adolescent Medicine, 154, 346–350. First citation in articleCrossref Medline, Google Scholar

  • Bergen, H., Hawton, K., Waters, K., Cooper, J., & Kapur, N. (2010). Epidemiology and trends in non-fatal self-harm in three centres in England, 2000 to 2007. British Journal of Psychiatry, 197, 493–498. First citation in articleCrossref Medline, Google Scholar

  • Bertolote, J. M., & Fleischmann, A. (2005). Suicidal behavior prevention: WHO perspectives on research. American Journal of Medical Genetics Part C: Seminars in Medical Genetics, 133C, 8–12. First citation in articleCrossref Medline, Google Scholar

  • Bertolote, J. M., & Fleischmann, A. (2009). Suicide thoughts, suicide plans and attempts in the general population on different continents. In Wasserman, D.Wasserman, C.Eds., The Oxford textbook of suicidology and suicide prevention: A global perspective, (pp. 99–104). Oxford, UK: Oxford University Press. First citation in articleGoogle Scholar

  • Borges, G., Nock, M. K., Haro Abad, J. M., Hwang, I., Sampson, N. A., Alonso, J., … Kessler, R. C. (2010). Twelve-month prevalence of and risk factors for suicide attempts in the World Health Organization World Mental Health Surveys. The Journal of Clinical Psychiatry, 71, 1617–1628. First citation in articleCrossref Medline, Google Scholar

  • Bossuyt, N. & Van Casteren, V. (2007). Epidemiology of suicide and suicide attempts in Belgium: Results from the sentinel network of general practitioners. International Journal of Public Health, 52, 153–157. First citation in articleCrossref Medline, Google Scholar

  • Carroll, R., Metcalfe, C., & Gunnell, D. (2014). Hospital management of self-harm patients and risk of repetition: Systematic review and meta-analysis. Journal of Affective Disorders, 168C, 476–483. First citation in articleCrossref, Google Scholar

  • Christiansen, E., Larsen, K. J., Agerbo, E., Bilenberg, N., & Stenager, E. (2013). Incidence and risk factors for suicide attempts in a general population of young people: A Danish register-based study. The Australian and New Zealand Journal of Psychiatry, 47, 259–270. First citation in articleCrossref Medline, Google Scholar

  • Corcoran, P., Keeley, H. S., O'Sullivan, M., & Perry, I. J. (2004). The incidence and repetition of attempted suicide in Ireland. European Journal of Public Health, 14, 19–23. First citation in articleCrossref Medline, Google Scholar

  • Danish Ministry of Health. (2013). Hovedpinepiller i store pakninger kommer på recept [Large packs of headache medication available on prescription only]. http://www.sum.dk/Aktuelt/Nyheder/Psykiatri/2013/April/Hovedpinepiller-i-store-pakninger-kommer-paa-recept.aspx First citation in articleGoogle Scholar

  • Data and Surveillance Task Force of the National Action Alliance for Suicide and Prevention. (2014). Improving national data systems for surveillance of suicide-related events. American Journal of Preventive Medicine, 47, S122–S129. First citation in articleGoogle Scholar

  • De Leo, D., Milner, A., Fleischmann, A., Bertolote, J., Collings, S., Amadeo, S., … Wang, X. (2013). The WHO START Study. Crisis, 34, 156–163. First citation in articleLink, Google Scholar

  • Erlangsen, A., Lind, B. D., Stuart, E. A., Qin, P., Stenager, E., Larsen, K. J., … Nordentoft, M. (2014). Short-term and long-term effects of psychosocial therapy for people after deliberate self-harm: A register-based, nationwide multicentre study using propensity score matching. The Lancet Psychiatry. Advance online publication. 10.1016/S2215-0366(14)00083-2 First citation in articleCrossref Medline, Google Scholar

  • Flavio, M., Martin, E., Pascal, B., Stephanie, C., Gabriela, S., Merle, K., … Anita, R. R. (2013). Suicide attempts in the county of Basel: Results from the WHO/EURO Multicentre Study on Suicidal Behaviour. Swiss Medical Weekly, 143, w13759. First citation in articleGoogle Scholar

  • Goldman-Mellor, S. J., Caspi, A., & Harrington, H. (2014). Suicide attempt in young people: A signal for long-term health care and social needs. JAMA Psychiatry, 71, 119–127. First citation in articleCrossref Medline, Google Scholar

  • Gray, D., Coon, H., McGlade, E., Callor, W. B., Byrd, J., Viskochil, J., … McMahon, W. M. (2014). Comparative analysis of suicide, accidental, and undetermined cause of death classification. Suicide and Life-Threatening Behavior, 44, 304–316. First citation in articleCrossref Medline, Google Scholar

  • Gunnell, D., Hawton, K., Murray, V., Garnier, R., Bismuth, C., Fagg, J., … Simkin, S. (1997). Use of paracetamol for suicide and non-fatal poisoning in the UK and France: Are restrictions on availability justified? Journal of Epidemiology and Community Health, 51, 175–179. First citation in articleCrossref Medline, Google Scholar

  • Haukka, J., Suominen, K., Partonen, T., & Lonnqvist, J. (2008). Determinants and outcomes of serious attempted suicide: A nationwide study in Finland, 1996-2003. American Journal of Epidemiology, 167, 1155–1163. First citation in articleCrossref Medline, Google Scholar

  • Hawton, K., Bergen, H., Simkin, S., Dodd, S., Pocock, P., Bernal, W., … Kapur, N. (2013). Long term effect of reduced pack sizes of paracetamol on poisoning deaths and liver transplant activity in England and Wales: Interrupted time series analyses. British Medical Journal, 346, f403. First citation in articleGoogle Scholar

  • Hawton, K., Rodham, K., Evans, E., & Harriss, L. (2009). Adolescents who self harm: A comparison of those go to general hospital and those who do not. Child and Adolescent Ment Health, 14, 24–30. First citation in articleCrossref, Google Scholar

  • Hawton, K., & van Heeringen, K. (2009). Suicide. Lancet, 373, 1372–1381. First citation in articleCrossref Medline, Google Scholar

  • Helweg-Larsen, K. (2006). Selvmord i Danmark [Suicide in Denmark]. Copenhagen: Statens Institut for Folkesundhed. First citation in articleGoogle Scholar

  • Kapusta, N. D., Tran, U. S., & Rockett, I. H. (2011). Declining autopsy rates and suicide misclassification: A cross-national analysis of 35 countries. Archives of General Psychiatry, 68, 1050–1057. First citation in articleCrossref Medline, Google Scholar

  • Kjartansdottir, I., Bergmann, O. M., Arnadottir, R. S., & Bjornsson, E. S. (2012). Paracetamol intoxications: A retrospective population-based study in Iceland. Scandinavian Journal of Gastroenterology, 47, 1344–1352. First citation in articleCrossref Medline, Google Scholar

  • Levinson, D., Haklai, Z., Stein, N., & Gordon, E. S. (2006). Suicide attempts in israel: Age by gender analysis of a national emergency departments database. Suicide and Life-Threatening Behavior, 36, 97–102. First citation in articleCrossref Medline, Google Scholar

  • Lynge, E., Sandegaard, J. L., & Rebolj, M. (2011). The Danish National Patient Register. Scandinavian Journal of Public Health, 39, 30–33. First citation in articleCrossref Medline, Google Scholar

  • Madsen, T., Agerbo, E., Mortensen, P. B., & Nordentoft, M. (2013). Deliberate self-harm before psychiatric admission and risk of suicide: Survival in a Danish national cohort. Social Psychiatry and Psychiatric Epidemiology, 48, 1481–1489. First citation in articleCrossref Medline, Google Scholar

  • Mors, O., Perto, G. P., & Mortensen, P. B. (2011). The Danish Psychiatric Central Research Register. Scandinavian Journal of Public Health, 39, 54–57. First citation in articleCrossref Medline, Google Scholar

  • Morthorst, B., Krogh, J., Erlangsen, A., Alberdi, F., & Nordentoft, M. (2012). Effect of assertive outreach after suicide attempt in the AID (assertive intervention for deliberate self harm) trial: Randomised controlled trial. British Medical Journal, 345, e4972. First citation in articleGoogle Scholar

  • Nock, M. K., Borges, G., Bromet, E. J., Alonso, J., Angermeyer, M., Beautrais, A., … Williams, D. (2008). Cross-national prevalence and risk factors for suicidal ideation, plans and attempts. The British Journal of Psychiatry, 192, 98–105. First citation in articleCrossref Medline, Google Scholar

  • Nordentoft, M. (2007). Prevention of suicide and attempted suicide in Denmark. Epidemiological studies of suicide and intervention studies in selected risk groups. Faculty of Health Sciences, Copenhagen University Hospital, Psychiatric Center Bispebjerg. First citation in articleGoogle Scholar

  • Nordentoft, M., & Sogaard, M. (2005). Registration, psychiatric evaluation and adherence to psychiatric treatment after suicide attempt. Nordic Journal of Psychiatry, 59, 213–216. First citation in articleCrossref Medline, Google Scholar

  • Pelkonen, M., & Marttunen, M. (2003). Child and adolescent suicide: Epidemiology, risk factors, and approaches to prevention. Paediatric Drugs, 5, 243–265. First citation in articleCrossref Medline, Google Scholar

  • Perry, I. J., Corcoran, P., Fitzgerald, A. P., Keeley, H. S., Reulbach, U., & Arensman, E. (2012). The incidence and repetition of hospital-treated deliberate self harm: Findings from the world's first national registry. PLoS.One., 7, e31663. First citation in articleGoogle Scholar

  • Platt, S., Bille-Brahe, U., Kerkhof, A., Schmidtke, A., Bjerke, T., Crepet, P., … Michel, K. (1992). Parasuicide in Europe: The WHO/EURO multicentre study on parasuicide. I. Introduction and preliminary analysis for 1989. Acta Psychiatrica Scandinavica, 85, 97–104. First citation in articleCrossref Medline, Google Scholar

  • Saberi-Zafaghandi, M. B., Hajebi, A., Eskandarieh, S., & Ahmadzad-Asl, M. (2012). Epidemiology of suicide and attempted suicide derived from the health system database in the Islamic Republic of Iran: 2001-2007. Eastern Mediterranean Health Journal, 18, 836–841. First citation in articleMedline, Google Scholar

  • Saxena, S., & Setoya, Y. (2014). World Health Organization's Comprehensive Mental Health Action Plan 2013-2020. Psychiatry and Clinical Neurosciences, 68, 585–586. First citation in articleCrossref Medline, Google Scholar

  • Silverman, M. M., Berman, A. L., Sanddal, N. D., O'Carroll, P. W., & Joiner, T. E. (2007). Rebuilding the tower of Babel: a revised nomenclature for the study of suicide and suicidal behaviors. Part 1: Background, rationale, and methodology. Suicide and Life-Threatening Behavior, 37, 248–263. First citation in articleCrossref Medline, Google Scholar

  • Spiller, H. A., Appana, S., & Brock, G. N. (2010). Epidemiological trends of suicide and attempted suicide by poisoning in the US: 2000−2008. Legal Medicine, 12, 177–183. First citation in articleCrossref Medline, Google Scholar

  • Statens Serum Institut. (2014). Fællesindhold for basisregistrering af sygehuspatienter [Joint manual for registation of hospital patients]. Retrieved from http://sundhedsdatastyrelsen.dk/da First citation in articleGoogle Scholar

  • Ting, S. A., Sullivan, A. F., Boudreaux, E. D., Miller, I., & Camargo, C. A., Jr. (2012). Trends in US emergency department visits for attempted suicide and self-inflicted injury, 1993-2008. General Hospital Psychiatry, 34, 557–565. First citation in articleCrossref Medline, Google Scholar

  • Tollefsen, I., Hem, E., & Ekeberg, O. (2012). The reliability of suicide statistics: A systematic review. BMC Psychiatry, 12, 9. First citation in articleCrossref Medline, Google Scholar

  • World Health Organization. (2014). Preventing suicide: A global imperative. Geneva, Switzerland: Author. First citation in articleGoogle Scholar