Abstract
Background
Although the number of older adults who engage in nonsuicidal self-injury (NSSI) is
not insignificant, research on older adults' NSSI is scant. The current study examined
the prevalence and characteristics of NSSI compared to suicide attempt (SA) in adults
older than 50 years who were seen at Emergency Departments (EDs) and their ED visit
outcomes.
Methods
Data came from the 2012 Nationwide Emergency Department Sample. We used binary logistic
regression analysis to examine demographic and clinical characteristics of NSSI versus
SA among 67,069 visits with a diagnosis of either SA or NSSI, and multinomial logistic
regression analysis to examine associations between NSSI versus SA and ED outcomes.
Results
Of self-inflicted intentional injuries, 76.89% were SA and 23.11% were NSSI. Visits
for NSSI were associated with lower levels of psychiatric disorders and alcohol use
disorders than SA and were more likely than SA visits to occur among older age groups
(65-74 and 75+), females, and those with multiple injuries and drug use disorders. NSSI visits
were also associated with greater risks of hospital admission (relative risk ratio
[RRR] = 1.45, 95% CI = 1.36-1.54) and death (RRR = 18.64, 95% CI = 14.19-24.49), as opposed to treat-and-release, but lower risks of facility transfer/discharge
with home health care (RRR = 0.77, 95% CI = 0.72-0.83).
Conclusions
The findings of higher hospitalization and death rates among those with NSSI than
SA show how lethal intentional self-destructive behaviors in late life can be even
if they are not classified as suicide attempts. The need for mental health and substance
abuse treatment is discussed.
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Article Info
Publication History
Published online: February 25, 2016
Accepted:
February 21,
2016
Received in revised form:
February 21,
2016
Received:
January 14,
2016
Identification
Copyright
© 2016 Elsevier Inc. All rights reserved.
