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Q In patients who present to the emergency department (ED) with self harm, can a simple clinical rule predict repetitions of self harm or suicide in the next 6 months?
Clinical impact ratings Paediatrics (general) ★★★★★★☆ Psychiatry ★★★★★★☆ Emergency medicine ★★★★★☆☆
prospective cohort study with separate derivation and validation data sets.
5 EDs in Manchester and Salford, UK.
9086 episodes of self harm (intentional self poisoning or self injury) in patients 11–98 years of age (median age 30 y, 56% women). Patients who did not wait for assessment or refused treatment were excluded.
Description of prediction guide:
the patient was considered to be at moderate or high risk of repeat self harm or suicide if any 1 of the 4 components of the Manchester Self Harm Rule was present: (1) history of self harm, (2) previous psychiatric treatment, (3) current psychiatric treatment, or …
For correspondence: Dr J Cooper, Centre for Suicide Prevention, University of Manchester, Manchester, UK.
Sources of funding: Manchester Health Authority; South Manchester University Hospitals NHS Trust; Central Manchester and Manchester Children’s University Hospitals NHS Trust; Pennine Acute NHS Trust; Mental Health Services of Salford NHS Trust.