Predicting the risk of repetition after self harm: cohort study

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Abstract
Four hospitals provide emergency care in the cities of Manchester and Salford. As part of the Manchester and Salford self harm project (MASSH) we collected data on all people aged at least 16 who presented with self harm in 1997-2001.3 Doctors in the emergency department and, for those patients who received a psychiatric assessment, mental health staff completed comprehensive assessment forms (which included demographic items as well as details of the self harm episode, past history, and current mental state). The assessor was also asked for a global clinical assessment of the risk of repetition of self harm (low, moderate, or high). We used the MASSH database to determine whether people repeated self harm within 12 months of their first presentation. We calculated sensitivity, specificity, and positive predictive value for emergency department and specialist mental health risk assessments.

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