ArticleJournal of affective disorders2016
Clinical management following self-harm in a UK-wide primary care cohort.
Article in Journal of affective disorders, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 18 papers, 2 of them syntheses that pooled it.
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Who cites it
18 citing papers in PubMed, 2 syntheses or guidelines pooled it, 51 citations in OpenAlex.
- Hospital presenting suicidal ideation: A systematic review.Clinical psychology & psychotherapy · 2022Pooled it
- Pharmacological interventions for self-harm in adults.The Cochrane database of systematic reviews · 2021Pooled it
- Results of a feasibility study of the FReSH START intervention to improve quality of life and other outcomes in people who repeatedly self-harm (Function REplacement in repeated Self-Harm: Standardising Therapeutic Assessment and the Related Therapy).Pilot and feasibility studies · 2025Article
- Article
- Article
- Emergency department presentations with suicide and self-harm ideation: a missed opportunity for intervention?Epidemiology and psychiatric sciences · 2023Article
- Accessing psychological therapies following self-harm: qualitative survey of patient experiences and views on improving practice.BJPsych open · 2023Article
- Impact of the COVID-19 pandemic on incidence of tics in children and young people: a population-based cohort study.EClinicalMedicine · 2023Article
- Examining drivers of self-harm guideline implementation by general practitioners: A qualitative analysis using the theoretical domains framework.British journal of health psychology · 2022Article
- Harm minimisation for self-harm: a cross-sectional survey of British clinicians' perspectives and practices.BMJ open · 2022Article
- Primary care clinical management following self-harm during the first wave of COVID-19 in the UK: population-based cohort study.BMJ open · 2022Article
- Effects of the COVID-19 pandemic on primary care-recorded mental illness and self-harm episodes in the UK: a population-based cohort study.The Lancet. Public health · 2021Article
- Healthcare professionals' implementation of national guidelines with patients who self-harm.Journal of psychiatric research · 2020Article
- Article
- Reducing risk following self-harm: the need for careful prescribing.The British journal of general practice : the journal of the Royal College of General Practitioners · 2019Article
- Continuity of Primary Care and Emergency Hospital Admissions Among Older Patients in England.Annals of family medicine · 2017Article
- Premature Death Among Primary Care Patients With a History of Self-Harm.Annals of family medicine · 2017Article
- Yonder: Self-harm, repeat prescribing, deprescribing, and worry.The British journal of general practice : the journal of the Royal College of General Practitioners · 2016Article
Corrections and comments
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Authors and funding
9 authors at 4 institutions in 1 country.
Funding
Abstract
backgroundLittle is known about the clinical management of patients in primary care following self-harm.
methodsA descriptive cohort study using data from 684 UK general practices that contributed to the Clinical Practice Research Datalink (CPRD) during 2001-2013. We identified 49,970 patients with a self-harm episode, 41,500 of whom had one complete year of follow-up.
resultsAmong those with complete follow-up, 26,065 (62.8%, 62.3-63.3) were prescribed psychotropic medication and 6318 (15.2%, 14.9-15.6) were referred to mental health services; 4105 (9.9%, CI 9.6-10.2) were medicated without an antecedent psychiatric diagnosis or referral, and 4,506 (10.9%, CI 10.6-11.2) had a diagnosis but were not subsequently medicated or referred. Patients registered at practices in the most deprived localities were 27.1% (CI 21.5-32.2) less likely to be referred than those in the least deprived. Despite a specifically flagged NICE 'Do not do' recommendation in 2011 against prescribing tricyclic antidepressants following self-harm because of their potentially lethal toxicity in overdose, 8.8% (CI 7.8-9.8) of individuals were issued a prescription in the subsequent year. The percentage prescribed Citalopram, an SSRI antidepressant with higher toxicity in overdose, fell sharply during 2012/2013 in the aftermath of a Medicines and Healthcare products Regulatory Agency (MHRA) safety alert issued in 2011.
conclusionsA relatively small percentage of these vulnerable patients are referred to mental health services, and reduced likelihood of referral in more deprived localities reflects a marked health inequality. National clinical guidelines have not yet been effective in reducing rates of tricyclic antidepressant prescribing for this high-risk group.
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