Self-harm in primary care: a clinical epidemiological study

Rationale
Self-harm is an act with a non-fatal outcome in which an individual deliberately initiates behaviour (such as self-cutting), or ingests a substance, an illicit drug or non-ingestible substance or object, with the intention of causing harm to themselves. It is a global health problem and is one of the strongest predictors of completed suicide. Current NICE guidelines identify primary care as having an ‘important role in the assessment and treatment of people who self-harm’ recommending that careful attention should be paid to ‘people at risk of self-harm’ (1). Yet, little is known about the characteristics of primary care attenders who are at risk of future self-harm and their health outcomes are unknown.

Aims & objectives
1. To determine childhood characteristics that are prospectively associated with incident self-harm, as presenting in primary care. 2. To determine patient-level characteristics that are predictive of new incidents of self-harm in primary care. 3. To determine the morbidity and mortality experiences of primary care patients presenting with self-harming behaviour.

Methods
The project will utilise data from the Clinical Practice Research Datalink (CPRD), the world’s largest population-based, longitudinal, primary care database. Data on morbidity and mortality will be obtained utilising linked data (Hospital Episode Statistics, Office of National Statistics Mortality data). During the research project, the doctoral student will learn the application of advanced statistical methods for epidemiological analysis.

When applying please select ’PhD in Social and Community Medicine’ from the Faculty of Health Sciences.