ArticlePloS one2019
A prospective study of repetition of self-harm following deliberate self-poisoning in rural Sri Lanka.
Article in PloS one, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers.
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Who cites it
9 citing papers in PubMed, 18 citations in OpenAlex.
- Trends of poisoning types in Sri Lanka: descriptive analysis of hospital admissions data 2004-2019.BMC public health · 2025Observational
- Family psychoeducation in schizophrenia and schizophrenia related disorder, treatment compliance, and suicidal risk reduction: questions about their relationship from a naturalistic observation.Frontiers in psychiatry · 2024Article
- Banning highly hazardous pesticides saves the lives of young people, particularly females, in low- and middle-income countries.BMC public health · 2023Article
- Associating factors of suicide and repetition following self-harm: A systematic review and meta-analysis of longitudinal studies.EClinicalMedicine · 2022Article
- Loss to follow-up in a population-wide brief contact intervention to prevent suicide attempts - The VigilanS program, France.PloS one · 2022Article
- Suicide reattempt in a population-wide brief contact intervention to prevent suicide attempts: The VigilanS program, France.European psychiatry : the journal of the Association of European Psychiatrists · 2021Article
- Exploration of associations between deliberate self-poisoning and psychiatric disorders in rural Sri Lanka: A case-control study.PloS one · 2021Article
- Clinical Characteristics of Pesticide Self-Harm as Associated with Suicide Attempt Repetition Status.Neuropsychiatric disease and treatment · 2020Article
- Risk of suicide and repeat self-harm after hospital attendance for non-fatal self-harm in Sri Lanka: a cohort study.The lancet. Psychiatry · 2019Article
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Authors and funding
5 authors at 3 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introductionRepetition of deliberate self-harm is an important predictor of subsequent suicide. Repetition rates in Asian countries appear to be significantly lower than in western high-income countries. Methodological differences in studies, and the impact of access to means of self-harm with comparatively higher lethality have been suggested as reasons for these reported differences. This prospective study determines the rates and demographic patterns of deliberate self-poisoning (DSP), suicide and repeated deliberate self-harm resulting non-fatal and fatal outcomes in rural Sri Lanka.
methodsDetails of DSP admission in all hospitals (n = 46) and suicides reported to all police stations (n = 28) in a rural district were collected for the years 2011, 2012 and 2013. Demographic details of the cohort of patients admitted to all hospitals in 2011 due to deliberate self-poisoning (N = 4022), were screened to link with patient records and police reports of the successive two years with high sensitivity using a computer program. Then high specificity manual matching of all screened links was performed to identify repetition within 2 years of initial presentation. Life time repetition was assessed in a randomly selected subset of DSP patients (n = 433).
resultsThere were 15,639 DSP admissions, aged more than 9 years, and 1078 suicides during the study period. The incidence of deliberate self-poisoning and suicide in the population within the study area were 248.3/100,000 and 20.7/100,000 respectively, in 2012. Repetition rates at four weeks, one-year and two-years were 1.9% (95% CI 1.5-2.3%), 5.7% (95% CI 5.0-6.4) and 7.9% (95% CI 7.1-8.8) respectively. The median interval between two attempts were 92 (IQR 10-238) and 191 (IQR 29-419.5) days for the one and two-year repetition groups. The majority of patients used the same poison in the repeat attempt. The age and duration of hospital stay of individuals with repetitive events were not significantly different from those who had no repetitive events. The rate of suicide at two years following DSP was 0.7% (95% CI 0.4-0.9%). The reported life time history of deliberate self-harm attempts was 9.5% (95% CI 6.7-12.2%).
conclusionsThe comparatively low rates of repetition in rural Sri Lanka was not explained by higher rates of suicide, access to more lethal means or differences in study methodology.
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