BMJ  2007;334:327 (17 February), doi:10.1136/bmj.39121.857569.1F

Letters

Suicide risk

Suicidal and self harming behaviours may be distinct

The first 150 words of the full text of this article appear below.

Classifying the method as well as the motivation of self harm is important since the physiological mechanisms lead to different perceived and actual outcomes.¹ If the motivation is truly suicidal, a non-fatal outcome is unsuccessful, but where the motivation is not suicidal, death is accidental.

Overdoses of drugs or poisons are more likely to be lethal and, if unsuccessful, to result in hospital admission, whereas self harm involving physical injury such as cutting or hitting an inanimate object is more commonly encountered in the community.

Suicide numbers in studies can be increased by including people who injure themselves using highly painful methods with low lethality, but suicide studies require differentiation between these groups to retain validity. If self harm patients who die accidentally are included this will have a skewing effect on postmortem studies of suicide.

In our clinical practices in the community we recognise many patients who regularly use . . . [Full text of this article]

¹ Synapse, Stirling FK8 1HF pdutton@health-psychology.co.uk, ² Davidson's Mains Medical Centre, Edinburgh EH4 5BP andrew.ashworth@lothian.scot.nhs.uk

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