Reexamining Doctoral Student Socialization and Professional Development: Moving Beyond the Congruence and Assimilation Orientation

Abstract

Background Background Non-fatal self-harm Non-fatal self-harm frequently leads to non-fatal repetition frequently leads to non-fatal repetition and sometimes to suicide.We need to and sometimes to suicide.We need to quantify these two outcomes of self-harm quantify these two outcomes of self-harm to help us to develop and test effective to help us to develop and test effective interventions. interventions. Aims Aims To estimate rates of fatal and To estimate rates of fatal and non-fatal repetition of self-harm. non-fatal repetition of self-harm. Method Method A systematic review of A systematic review of published follow-up data, from published follow-up data, from observational and experimental studies. observational and experimental studies. Four electronic databases were searched Four electronic databases were searched and 90 studies metthe inclusion criteria. and 90 studies metthe inclusion criteria. Results Results Eighty per cent of studies found Eighty per cent of studies found were undertaken in Europe, over one-were undertaken in Europe, over one-third in the UK. Median proportions for third in the UK.Median proportions for repetition1year later were: 16% non-fatal repetition1year later were: 16% non-fatal and 2% fatal; after more than 9 years, and 2% fatal; after more than 9 years, around 7% of patients had died by suicide. around 7% of patients had died by suicide. The UK studies found particularly low The UK studies found particularly low rates of subsequent suicide. rates of subsequent suicide. Conclusions Conclusions After1year, non-fatal After1year, non-fatal repetition rates are around15%.The repetition rates are around15%.The strong connection between self-harm and strong connection between self-harm and later suicide lies somewhere between later suicide lies somewhere between 0.5% and 2% after1year and above 5% 0.5% and 2% after1year and above 5% after 9 years. Suicide risk among self-harm after 9 years. Suicide risk among self-harm patientsis hundreds oftimes higher than in patientsis hundreds oftimes higher than in the general population. the general population.