Evidence map›Paper›PMID 35165109›Full record

ArticleBMJ open2022

Primary care clinical management following self-harm during the first wave of COVID-19 in the UK: population-based cohort study.

Sarah Steeg, Matthew Carr, Laszlo Trefan, Darren Ashcroft, Navneet Kapur, Emma Nielsen, Brian McMillan, Roger Webb

Open access · goldAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in BMJ open, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
8citing papers in PubMed, 1 pooled it
1.5field-weighted citation impact, top 19% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

8 citing papers in PubMed, 1 synthesis or guideline pooled it, 10 citations in OpenAlex.

  1. Pooled it
  2. Review
  3. Exploring General Practitioners' Management of Self-Harm in Young People: A Qualitative Study.Health expectations : an international journal of public participation in health care and health policy · 2024
    Article
  4. Article
  5. Review
  6. Observational
  7. Article
  8. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors at 3 institutions in 3 countries.

Sarah SteegCentre for Mental Health and Safety, University of Manchester, Manchester, UK sarah.steeg@manchester.ac.uk.ORCID 0000-0002-7935-1414
Matthew CarrCentre for Mental Health and Safety, University of Manchester, Manchester, UK.
Laszlo TrefanCentre for Mental Health and Safety, University of Manchester, Manchester, UK.
Darren AshcroftManchester Academic Health Science Centre, University of Manchester, Manchester, UK.
Navneet KapurCentre for Mental Health and Safety, University of Manchester, Manchester, UK.
Emma NielsenSelf-harm Research Group, School of Psychology, University of Nottingham, Nottingham, UK.
Brian McMillanCentre for Primary Care and Health Services Research, University of Manchester, Manchester, UK.ORCID 0000-0002-0683-3877
Roger WebbCentre for Mental Health and Safety, University of Manchester, Manchester, UK.
Manchester Academic Health Science Centre · GBGreater Manchester Mental Health NHS Foundation Trust · GBUniversity of Nottingham · GB

Funding

Medical Research Council MR/V02843X/1
6 · The paper itself

Abstract

objectivesA substantial reduction in self-harm recorded in primary care occurred during the first wave of COVID-19 but effects on primary care management of self-harm are unknown. Our objectives were to examine the impact of COVID-19 on clinical management within 3 months of an episode of self-harm.

designRetrospective cohort study.

settingUK primary care.

participants4238 patients with an index episode of self-harm recorded in UK primary care during the COVID-19 first-wave period (10 March 2020-10 June 2020) compared with 48 739 patients in a prepandemic comparison period (10 March-10 June, 2010-2019). OUTCOME MEASURES: Using data from the UK Clinical Practice Research Datalink, we compared cohorts of patients with an index self-harm episode recorded during the prepandemic period versus the COVID-19 first-wave period. Patients were followed up for 3 months to capture subsequent general practitioner (GP)/practice nurse consultation, referral to mental health services and psychotropic medication prescribing. We examined differences by gender, age group and Index of Multiple Deprivation quintile.

resultsLikelihood of having at least one GP/practice nurse consultation was broadly similar (83.2% vs 80.3% in the COVID-19 cohort). The proportion of patients referred to mental health services in the COVID-19 cohort (4.2%) was around two-thirds of that in the prepandemic cohort (6.1%). Similar proportions were prescribed psychotropic medication within 3 months in the prepandemic (54.0%) and COVID-19 first-wave (54.9%) cohorts.

conclusionsDespite the challenges experienced by primary healthcare teams during the initial COVID-19 wave, prescribing and consultation patterns following self-harm were broadly similar to prepandemic levels. We found no evidence of widening of digital exclusion in terms of access to remote consultations. However, the reduced likelihood of referral to mental health services warrants attention. Accessible outpatient and community services for people who have self-harmed are required as the COVID-19 crisis recedes and the population faces new challenges to mental health.

Indexed as

COVID-19Self-Injurious BehaviorCohort StudiesHumansPrimary Health CareRetrospective StudiesSARS-CoV-2United KingdomCOVID-19primary carepublic healthsuicide & self-harm

Identifiers

PMID35165109
PMCPMC8844953
OpenAlexW4213269445

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.