Table 1.

Characteristics of included studies (n = 20).

Study	Type	No. of Participants	Setting	Age	Diagnosis	Study Length	Self-Harm Method	Previous or Subsequent Attempt	Death	Influencing Factors/Precipitants
AbuMadidi et al. (2001)	Retrospective study (chart review)	398	ED, Saudi Arabia	13–74 years	AD 30.1%; personality disorder 32%, depression 8.6%	6 years	78.7% poisoning; 26% cutting	Previous attempt in 21.5%	Not stated	Females more likely to have dx AD (p < 0.01), stressful life events (p < 0.001). Males more likely to have substance misuse (p < 0.001), psychosis (p < 0.01)
Brakoulias et al. (2006)	Retrospective study (chart review)	1295	Liaison psychiatry service, Australia	18–88 years	AD 35.9%; major depression %; schizophrenia	5 years	79.2% poisoning; 12.7% cutting; 4.7% violent	12% prior self-harm	Not stated	Women more likely to poison, men more likely to cut or violent act. Separated and divorced women 18–24 high risk. Violent group, AD less common than depression or schizophrenia.
Briskman et al. (2017)	Prospective cohort study	1149	ED Israel	18–95 years	AD 48% most common diagnosis, personality 16%; depression; 15% depression	8 years	92.5% poisoning; 7.5% hanging; cutting	30%	Not stated	AD 46.7% aged 16–64, 57.8% in >65 years
Casey et al., (2015)	Prospective cohort study	348	Liaison psychiatry services in 3 Dublin Hospitals	Mean age in AD with suicidal behaviour 36.5 years	AD 49.7%; depressive episode 51.3%	6 months	Not stated	Not stated	None	Younger age, single marital status and greater severity of depressive symptoms.
Farzeneh et al. (2010)	Cross-sectional cohort study	248	ED, Iran	12–18 years	AD 84.3%; major depression 18%; personality disorder 10%	Not stated	Self-poisoning	Not stated	Not stated	Female—80.64%, childhood adversity—48%, family psychiatric history—33%, substances—11%
Galgali et al. (1998)	Retrospective study (chart review)	119	ED, India	Mean age 25 years	AD 33.7%; depression 21%; schizophrenia 4.3%	One year	Self-poisoning—most common being pesticides	9.24% of the sample had a previous attempt	Not stated/unknown	Substance abuse, epilepsy, co-morbid psychiatric illnesses
Ghimire et al. (2012)	Retrospective study (chart review)	200	ED, Nepal	15–55 and above. 77% below the age of 34 years	AD 13.5%; mood disorder 11%; substance abuse 7%	3 months	Self-poisoning by various compounds, pesticides being the most common	Not reported	Not reported	Gender, substance abuse, interpersonal conflict
Grundikoff et al. (2015)	Retrospective study (chart review)	265 93 self-harm	ED, New York	0–17 years	AD 417.7%	1 year	Not reported	57 (22.4%)	Not reported	Family conflict—30% suicidal ideation, 41% self-harm. Peer conflict—30% suicidal ideation, 41% self-harm.
Huyse et al. (2001)	Cross-sectional cohort study	1795 self-harm Total in study 10560	Liaison psychiatry services in 11 European countries	Mean age presenting with self-harm 38 years	Self-harm 17%; AD 12.4%	1 year	Not reported	Not reported	Not reported	Self-harm 56% female, 24% transferred to psychiatric ward
Lin et al. (2012)	Retrospective study (chart review)	73	Medical admissions, Taiwan	16–83 years	AD 41.1%; depression 49.3%	10 years	Charcoal burning	Not reported	Not reported	Stressors included end of relationship (18%), debt (18%) and illness (18%). Male patients had higher rates of AD, comorbid with alcohol abuse.
Lin et al. (2018)	Retrospective study (chart review)	174	Medical admissions, Taiwan	Mean 45.8 years (SD20) rodenticide group; 41.2 years (SD 14.9) paraquat group	AD n = 17 (9.8%)—2(3.2%) rodenticide group; 15(14.1%) paraquat group	12 years	Self-poisoning by either rodenticide or paraquat	n = 17 (9.8%)—3(7.6%) rodenticide group; 45(30%) paraquat group	87 (50%) total 0 rodenticide group; 87 (58%) paraquat group. No detail by diagnosis	AD significantly associated with presentation with paraquat poisoning (high lethality group)
Lingeswaren et al. (2016)	Prospective cohort study	40	Medical admissions, India	10–30 years	Acute stress reaction/Adjustment disorder in 100%	6 months	Self-poisoning	1 participant had a previous suicide attempt	Death by suicide was an exclusion criterion of this study	Female—62.5% Stressors included parenting issues 47.5%, interpersonal difficulties 30%, academic 7%
Magat et al. (2008)	Retrospective study (chart review)	65	Tertiary centre in Honolulu, Hawaii	5–18 years	AD 29%; depressive illness (45%)	2 years	Self-poisoning	26%	None	Gender (female) 86%, age 13–16 68%
McCauley et al. (2001)	Retrospective study (chart review)	70	ED, rural hospital, Ireland	10 to >60 years	AD 35.78%; depressive disorder (28.6%); schizophrenia 7.1%	1 year	92.9% overdose; 1.4% each for drowning, hanging, inhaling exhaust fumes, laceration of wrists	Absence or presence of previous suicidal behaviour is documented in 47.7% of charts.	None	Gender Female: Male 2:1, alcohol implicated in 47% of cases
Mitrev (1996)	Prospective descriptive study	140	Toxicological unit, Germany	15 to >60 years	AD 100%, no additional diagnosis	2 years	Self-poisoning	20% had a prior suicide attempt	None	Interpersonal conflict—70%, occupational/ economic—25%
Polyakova, 1998	Prospective observational study	155	ED, Moscow	18–65 years	AD 55.5%; depression 44.5%	9 months	AD group poisoning n = 60 (70%: males 19, 22%, female 41, 48%); hanging 17 (20%: males 12, 14%, female 5, 6%); other 9 (10%: males 4, 5%, female 5, 5%)	Not reported	None	AD less educated, lower social status, unmarried. Majority unfavourable childhood events. Alcohol 3 times more likely to be involved in AD than depression, more impulsive. AD regretted (92%, compared with only 12% in the depression group)
Suss et al. (2004)	Cross sectional cohort study	92	ED, New York	12–18 years	AD 77% of the more serious suicide attempts and 50% of the less serious suicide attempts. Other diagnoses are not listed	2 years	Self-poisoning	32% had previous suicide attempt, with 6% having two or more previous attempts	None–the study was conducted exclusively on non-fatal suicide attempts	Gender—86% of participants were female. Ethnicity 82% of participants were African American
Taggart et al. (2006)	Prospective cohort study	125 self-harm, of 167 patients in study	ED, Belfast	13–77 years	AD—49 (31.8%) clinically; 12 (7.8) SCID Depression 30 (19.5%) clinically; 56 (36.4%) SCID	1 year	Poisoning 104 (83.2%); cutting 10 (8%); other 11 (8.8%)	129 (83.8%) prior self-harm, 25 (16.4) >x2 Figures given for whole sample, figures for those presenting with self-harm not described separately	Not reported	54.5% female, 45.5% male. 67.5% previous psychiatric treatment.
Wai et al. (1999)	Retrospective study (chart review)	214	ED and medical admissions, Singapore	13–21 years	AD (53.5%), Major depression (24.3%), Schizophrenia (1.9%) Substance misuse (0.5%)	4 years	90% poisoning; 6% mixed; 4% violent incl defenestration	Not reported	Not reported	Family conflict 24.5%; conflict with friends 23.6%; school problems 11%; military service in 10% of males.
Zhargami et al. (2002)	Prospective descriptive study, included psychological autopsy	318	Burns unit, Iran	No age range given. Average age of 27 years stated	AD 42.1%; major depression 11%; anxiety d/o 4.7%; schizophrenia 4.1%	Initial interviews over 2-year period, follow up interviews 8 years later	Self-immolation	27% of cases had a previous suicide attempt	242 or 79% of the study group died as a result of self-immolation	Marital conflict (30%), family problems (12%), “love affair” (10%), conflict with spouse’s family (5%)