Hostname: page-component-78c5997874-xbtfd Total loading time: 0 Render date: 2024-11-10T20:05:11.222Z Has data issue: false hasContentIssue false
  • English
  • Français

The timing of deliberate self harm behaviour

Published online by Cambridge University Press:  13 June 2014

Paul Blenkiron
Paul Blenkiron*
Affiliation:
Bootham Park Hospital, York YO30 7BY, England, and Honorary Senior Lecturer, Academic Department of Psychiatry, University of Leeds, England
Get access Rights & Permissions [Opens in a new window]

Abstract

Objectives: To critically review the scientific literature relating to the timing of deliberate self harm behaviour and completed suicide.

Method: A literature search of the Medline and CINAHL databases from 1970-2002 was performed, using deliberate self harm, overdose, self poisoning, suicide, parasuicide, and time, timing, day, week, month and season as key words. Relevant secondary references were retrieved and hand searching of important journals was done.

Results: The time of day of non-fatal self harm shows a marked diurnal variation, with an evening peak that is related to non-violent episodes, concomitant alcohol use, and a younger age. It is not conclusively linked to the degree of suicidal intent or particular psychiatric diagnoses. Completed suicides more commonly occur earlier in the day, at the beginning of the week and during springtime, but show no overall increase during many national events and holidays.

Conclusions: Circadian biological mechanisms involving the serotonin-melatonin axis, Cortisol secretion and sleep abnormalities appear to be implicated. Psychosocial explanations for these epidemiological findings include alcohol use, a sense of personal isolation and the ‘broken promise’ effect.

Keywords

SuicideSelf harmTimingCircadianSeasonal
Type
Reviews
Information
Irish Journal of Psychological Medicine , Volume 20 , Issue 4 , December 2003 , pp. 126 - 131
Copyright
Copyright © Cambridge University Press 2003

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1.Lejoyeux, M, Leon, E, Rouillon, F. Prevalence and risk factors of suicide and attempted suicide. Encephale 1994; 20(5): 495–503.Google ScholarPubMed
2.Manfredini, R, Gallerani, M, Caracciolo, S, et al.Circadian variation in attempted suicide by deliberate self-poisoning. BMJ 1994; 309: 774–5.CrossRefGoogle ScholarPubMed
3.Blenkiron, P, House, A, Milnes, D. The timing of acts of deliberate self harm: is there any relation with suicidal intent, mental disorder or psychiatric management? J Psychosomatic Res 2000; 49: 3–6.CrossRefGoogle ScholarPubMed
4.Buckley, NA, Whyte, IM, Dawson, AH. There are days ….and moons. Self-poisoning is not lunacy. Med J Australia 1993; 159(11-12): 786–9.CrossRefGoogle Scholar
5.Caracciolo, S, Manfredini, R, Gallerani, M, Tugnoli, S. Circadian rhythm of parasuicide in relation to violence of method and concomitant mental disorder. Acta Psychiatrica Scand 1996; 93(4): 252–6.CrossRefGoogle ScholarPubMed
6.De Maio, D, Carandente, F, Riva, C. Evaluation of circadian, circaseptan, and circannual periodicity of attempted suicides. Chronobiologica 1982; 9(2): 185–93.Google ScholarPubMed
7.Raymond, RC, Warren, M, Morris, RW, Leiken, JB. Periodicity of presentations of drugs of abuse and overdose in an emergency department. J Toxicology 1992; 30(3): 467–78.Google ScholarPubMed
8.Owens, DW, Jones, SJ. The accident and emergency department management of deliberate self-poisoning. Br J Psychiatry 1988; 152: 830–833.CrossRefGoogle ScholarPubMed
9.Schmitt, W, Mundt, C. Differential typology among patients with hard and soft suicide methods. Nervenarzt 1991; 62(7): 440–4.Google ScholarPubMed
10.Morselli, H. Suicidio. English edition. London: Kegan Paul, 1881: 77–79Google Scholar
11.Durkeim, E. Le Suicide. 1897: 116. Paris: F Alcan. American Edition published Glencoe: Free Press, 1951.Google Scholar
12.Pokorney, AD, Characteristics of 44 patients who subsequently committed suicide. Arch Gen Psychiatry 1960; 2: 314–323.CrossRefGoogle Scholar
13.Vollen, KH, Watson, CG. Suicide in relation to time of day and day of week. Am J Nursing 1975; 75(2): 263.CrossRefGoogle ScholarPubMed
14.Barraclough, BM. Time of day chosen for suicide. Psychol Med 1976; 6(2: 303–5.CrossRefGoogle ScholarPubMed
15.Schmidtke, A. Suicidal behaviour on railways in the Federal Republic of Germany. Soc Sci Med 1994; 38(3): 419–26.CrossRefGoogle Scholar
16.Williams, P, Tansella, M. The time for suicide. Acta Psychiatrica Scand 1987; 75: 532–535.CrossRefGoogle ScholarPubMed
17.MacMahon, K. Short-term temporal cycles in the frequency of suicide in the United States, 1972-1978. Am J Epidemiology 1983; 117(6): 744–50.CrossRefGoogle ScholarPubMed
18.Lejoyeux, M, Leon, E, Rouillon, F. Prevalence and risk factors of suicide and attempted suicide. Encephale 1994; 20(5): 495–503.Google ScholarPubMed
19.Parker, G, Walter, SS. Seasonal variation in depressive disorders and suicidal deaths in New South Wales. Br J Psychiatry 1982; 140: 626–632.CrossRefGoogle ScholarPubMed
20.Hakko, H, Rasanen, P, Tiihonen, J. Seasonal variation in suicide occurrence in Finland. Acta Psychiatrica Scand 1998; 98: 92–97.CrossRefGoogle ScholarPubMed
21.Barker, A, Hawton, K, Fagg, J, Jennison, CSeasonal and weather factors in parasuicide. Br J Psychiatry 1994; 165: 375–380.CrossRefGoogle ScholarPubMed
22.Masterton, G. Monthly and seasonal variation in parasuicide: a sex difference. Br J Psychiatry 1991; 158: 155–7.CrossRefGoogle ScholarPubMed
23.Registrar-General for England and Wales. Statistical review part III, 210. London: Her Majesty's Stationary Office, 1961.Google Scholar
24.National Police Agency of Japan. Japanese complacency over its collapsing economy. News article by P Tasker. Financial Mail on Sunday. 1998; June 21: 3.Google Scholar
25.Office of Health Economics. Suicide and deliberate self-harm. London: Office of Health Economics, 1981Google Scholar
26.Hawton, K, Townsend, E, Decks, Jet al.Effects of legislation restricting pack sizes of paracetamol and salicylate on self poisoning in the United Kingdom; before and after study. Br Med J 2001; 322: 1203.CrossRefGoogle ScholarPubMed
27.Hawton, K, Van Heeringen, K. The International Handbook of Suicide and Attempted Suicide. Chichester, UK: Wiley, 2002Google Scholar
28.Cullum, SJ, Catalan, J, Berelowitz, K, O'Brien, S, Millington, HT, Preston, D. Deliberate self-harm and public holidays: is there a link? Crisis 1993; 14(1): 39–42.Google ScholarPubMed
29.Jessen, G, Jensen, BF, Arensman, Eet al.Attempted suicide and major public holidays in Europe: findings from the WNO/EURO Multicentre Study on Parasuicide. Acta Psychiatrica Scand 1999; 99: 412–418.CrossRefGoogle Scholar
30.Ekeberg, O, Jacobson, D, Sorum, Y, Aass, G. Self-poisoning and the menstrual cycle. Acta Psychiatrica Scandinavica 1986, 73(3), 239–41.CrossRefGoogle ScholarPubMed
31.Masterton, G, Piatt, S. Parasuicide and general elections. BMJ 1989; 298: 803–804.CrossRefGoogle ScholarPubMed
32.Daradkeh, TK. Parasuicide during Ramadan in Jordan. Acta Psychiatrica Scand 1992; 86(3): 253–4.CrossRefGoogle Scholar
33.Mitchell, JR. There was no ‘Diana Effect’ on numbers of psychiatric emergencies (letter). BMJ 1998; 316: 1751.Google Scholar
34.Carroll, D, Ebrahim, S, Tilling, K, Macleod, J, Davey Smith, D. Admissions for myocardial infarction and World Cup football: database survey. BMJ 2002; 325: 1439–42.CrossRefGoogle ScholarPubMed
35.Hawton, K, Simkin, S, Deeks, JJet al.Effects of a drug overdose in a television drama on presentations for self-poisoning: time series and questionnaire study. BMJ 1999; 318: 972–7.CrossRefGoogle Scholar
36.Stack, S. Media impacts on suicide: a qualitative review of 293 findings. Paper presented at the Annual meeting of the American Association of Suicidology, Houston, Texas, 1999Google Scholar
37.Pirkis, J, Blood, RW. Suicide and the media: a critical review. Canberra: Commonwealth Department of Health and Aged Care, 2001Google Scholar
38.Hawton, K, Wlliams, K. Influences of the media on suicide. BMJ 2002; 325: 1374–5.CrossRefGoogle ScholarPubMed
39.Rockwell, DA, Wnget, CM, Rosenblatt, LS, Higgins, EA, Hetherington, NW. Biological aspects of suicide. J Nervous & Mental Disease 1978; 166(12): 851–8.CrossRefGoogle ScholarPubMed
40.Blenkiron, P. Deliberate self harm and time of day: is there any relationship with suicidal intent, coexisting mental disorder or subsequent psychiatric outcome? Dissertation for the degree of Master of Medical Science in Clinical Psychiatry, University of Leeds School of Medicine, UK, 1999Google Scholar
41.Asberg, M, Traskman, L, Thoren, P. 5-HIAA in the cerebrospinal fluid: a biochemical suicide predictor? Arch Gen Psychiatry 1976; 33: 1193–1197.CrossRefGoogle ScholarPubMed
42.Sandyk, R, Awerbuch, GI. Nocturnal melatonin secretion in suicidal patients with multiple sclerosis. Int J Neuroscience 1993; 71(1-4): 173–82.CrossRefGoogle ScholarPubMed
43.Haus, E, Nicolau, GY, Lakatua, D, Sackett-Lundeen, L. Reference values for chronopharmacology. Ann Rev Chronopharmacology 1988; 4: 333–424.Google Scholar
44.Pine, DS, Trautman, PD, Shaffer, D, Cohen, L, Davies, M, Stanley, M, Parsons, B. Seasonal rhythm of platelet [3H] binding in adolescents who attempted suicide. Am J Psychiatry 1995; 152(6): 923–5.Google ScholarPubMed
45.De Leo, D, Pellegrini, C, Serraiotfo, L, Magni, G, De Toni, R. Assessment of severity of suicide attempts. A trial with the dexamethasone suppression test and two rating scales. Psychopathology 1986; 19(4): 186–91.CrossRefGoogle Scholar
46.Van Wettere, JP, Charles, G, Wilmotte. Dexamethasone suppression test and suicide. Acta Psychiatrica Belgica 1983; 83(6): 569–78.Google ScholarPubMed
47.Prasad, AJ. Neuroendocrine differences between violent and non-violent parasuicides. Neuropsychobiology 1985; 13(4): 157–9.CrossRefGoogle ScholarPubMed
48.Sabo, EM, Reynolds, CF, Kupfer, DJ, Berman, SR, Sleep, depression and suicide. Psychiatry Research 1991; 36(3): 265–77.CrossRefGoogle ScholarPubMed
49.Keshavan, MS, Reynolds, CF, Montrose, D, Miewald, J, Downs, C, Sabo, EM. Sleep and suicidality in psychotic patients. Acta Psychiatrica Scand 1994; 89(2): 22–5.CrossRefGoogle ScholarPubMed
50.Wirz-Justice, A, Van den Hoofdakker, RH. Sleep deprivation in depression: what do we know, where do we go? Biol Psychiatry 1999; 56: 445–53.CrossRefGoogle Scholar
51.Rotenberg, VS. (2003) Sleep deprivation in depression: an integrative approach. Int J Psychiatry Clin Practice 2003; 7: 9–16.CrossRefGoogle ScholarPubMed
52.Sainsbury, P. The epidemiology of suicide. In: Roy, A, ed. Suicide. Baltimore: Williams AWilkins, 1986.Google Scholar
53.Michel, K, Valach, L, Waeber, V. Understanding deliberate self harm: the patients' views. Crisis 1994; 15(4): 172–8.Google ScholarPubMed
54.Motohashi, Y. Circadian variation in suicide attempts in Tokyo from 1978-1985. Suicide and Life-Threatening Behaviour 1990; 20(4): 352–61.CrossRefGoogle Scholar
55.Kasper, S, Wehr, TA, Bartko, JJ, Gaist, PA, Rosenthal, NE. (1989). Epidemiological findings of seasonal changes in mood and behaviour. Arch Gen Psychiatry 1989; 46: 823–33.Google Scholar
56.Yip, PS, Chao, A, Chiu, CWF. Seasonal variation in suicides: diminished or vanished. Br J Psychiatry 2000; 177: 366–369.CrossRefGoogle ScholarPubMed
57.Gabennesch, H. When promises fail: a theory of temporal fluctuations in suicide. Soc Forces 1988; 67: 129–145.CrossRefGoogle Scholar