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Research article:

Short- and long-term risk of premature death in a nationally representative cohort of primary care patients with history of self-harm

Reference:

Matthew J. Carr, Darren M. Ashcroft, Evangelos Kontopantelis, David While, Yvonne Awenat, Jayne Cooper, Carolyn Chew-Graham, Nav Kapur, Roger T. Webb (2016) Short- and long-term risk of premature death in a nationally representative cohort of primary care patients with history of self-harm. BMJ, doi:

Link to article
Abstract
Objectives: To examine premature mortality in a nationally representative cohort of primary care patients who have harmed themselves, and to estimate relative risks versus the general population stratified by follow-up time from first to tenth year. Design: Matched cohort study. Setting: 385 general practices in England contributing data to the Clinical Practice Research Datalink (CPRD) during 2001-2013 with linkage to national mortality records. Population: Index cohort of 30,017 persons aged 15-64 years with a record of self-harm; comparison cohort, sampled from the same population, consisting of 600,258 persons with no record of self-harm and matched to index patients on age (year of birth), gender and registered general practice. Main outcome measures: Hazards ratios for all-cause and cause-specific mortality, including unnatural vs. natural death, suicide, intentional vs. accidental poisoning, and alcohol-related death. Results: We found greatly raised risk of dying prematurely from any cause among members of the self-harm cohort, especially so during the first follow-up year: hazard ratio (HR) 9.9, 95% confidence interval (CI) 8.6 to 11.4. The elevation in suicide risk within a year was especially great (HR 113.9, CI 73.9 to 175.6). Beyond the first follow-up year, suicide risk declined sharply but remained much higher than in the comparison cohort. Large risk elevations throughout the follow-up period were observed for accidental self-poisoning and alcohol-related death. Conclusions: Primary care patients who have harmed themselves are at greatly increased risk of dying prematurely by suicide and by other causes, and especially so within a year of the index episode. Relatively frequent general practice attendance by these individuals presents a clear opportunity for preventive action in primary care. National clinical guidelines could provide more specific recommendations for how primary healthcare teams can monitor, intervene and manage risk in these patients more effectively.
Author for correspondence
Matthew J Carr
Email for correspondence
matthew.carr@manchester.ac.uk

Code list: res41: Self-harm

261 codes in list

Code Coding system Description Entity type List name
14K1.00 Read Intentional overdose of prescription only medication diagnostic res41: Self-harm
SL...14 Read Overdose of biological substance diagnostic res41: Self-harm
SL...15 Read Overdose of drug diagnostic res41: Self-harm
SL90.00 Read Antidepressant poisoning diagnostic res41: Self-harm
SL90z00 Read Anti-depressant poisoning NOS diagnostic res41: Self-harm
SLHz.00 Read Drug and medicament poisoning NOS diagnostic res41: Self-harm
TK...00 Read Suicide and selfinflicted injury diagnostic res41: Self-harm
TK0..00 Read Suicide + selfinflicted poisoning by solid/liquid substances diagnostic res41: Self-harm
TK00.00 Read Suicide + selfinflicted poisoning by analgesic/antipyretic diagnostic res41: Self-harm
TK01.00 Read Suicide + selfinflicted poisoning by barbiturates diagnostic res41: Self-harm
TK01000 Read Suicide and self inflicted injury by Amylobarbitone diagnostic res41: Self-harm
TK01100 Read Suicide and self inflicted injury by Barbitone diagnostic res41: Self-harm
TK01400 Read Suicide and self inflicted injury by Phenobarbitone diagnostic res41: Self-harm
TK02.00 Read Suicide + selfinflicted poisoning by oth sedatives/hypnotics diagnostic res41: Self-harm
TK03.00 Read Suicide + selfinflicted poisoning tranquilliser/psychotropic diagnostic res41: Self-harm
TK04.00 Read Suicide + selfinflicted poisoning by other drugs/medicines diagnostic res41: Self-harm
TK05.00 Read Suicide + selfinflicted poisoning by drug or medicine NOS diagnostic res41: Self-harm
TK06.00 Read Suicide + selfinflicted poisoning by agricultural chemical diagnostic res41: Self-harm
TK07.00 Read Suicide + selfinflicted poisoning by corrosive/caustic subst diagnostic res41: Self-harm
TK0z.00 Read Suicide + selfinflicted poisoning by solid/liquid subst NOS diagnostic res41: Self-harm
TK1..00 Read Suicide + selfinflicted poisoning by gases in domestic use diagnostic res41: Self-harm
TK10.00 Read Suicide + selfinflicted poisoning by gas via pipeline diagnostic res41: Self-harm
TK...11 Read Cause of overdose - deliberate diagnostic res41: Self-harm
TK11.00 Read Suicide + selfinflicted poisoning by liquified petrol gas diagnostic res41: Self-harm
TK...12 Read Injury - self-inflicted diagnostic res41: Self-harm
TK...13 Read Poisoning - self-inflicted diagnostic res41: Self-harm
TK...14 Read Suicide and self harm diagnostic res41: Self-harm
TK...15 Read Attempted suicide diagnostic res41: Self-harm
TK...17 Read Para-suicide diagnostic res41: Self-harm
TK1y.00 Read Suicide and selfinflicted poisoning by other utility gas diagnostic res41: Self-harm
TK1z.00 Read Suicide + selfinflicted poisoning by domestic gases NOS diagnostic res41: Self-harm
TK2..00 Read Suicide + selfinflicted poisoning by other gases and vapours diagnostic res41: Self-harm
TK20.00 Read Suicide + selfinflicted poisoning by motor veh exhaust gas diagnostic res41: Self-harm
TK21.00 Read Suicide and selfinflicted poisoning by other carbon monoxide diagnostic res41: Self-harm
TK2z.00 Read Suicide + selfinflicted poisoning by gases and vapours NOS diagnostic res41: Self-harm
TK3..00 Read Suicide + selfinflicted injury by hang/strangulate/suffocate diagnostic res41: Self-harm
TK30.00 Read Suicide and selfinflicted injury by hanging diagnostic res41: Self-harm
TK31.00 Read Suicide + selfinflicted injury by suffocation by plastic bag diagnostic res41: Self-harm
TK3y.00 Read Suicide + selfinflicted inj oth mean hang/strangle/suffocate diagnostic res41: Self-harm
TK3z.00 Read Suicide + selfinflicted inj by hang/strangle/suffocate NOS diagnostic res41: Self-harm
TK4..00 Read Suicide and selfinflicted injury by drowning diagnostic res41: Self-harm
TK5..00 Read Suicide and selfinflicted injury by firearms and explosives diagnostic res41: Self-harm
TK51.00 Read Suicide and selfinflicted injury by shotgun diagnostic res41: Self-harm
TK52.00 Read Suicide and selfinflicted injury by hunting rifle diagnostic res41: Self-harm
TK54.00 Read Suicide and selfinflicted injury by other firearm diagnostic res41: Self-harm
TK5z.00 Read Suicide and selfinflicted injury by firearms/explosives NOS diagnostic res41: Self-harm
TK6..00 Read Suicide and selfinflicted injury by cutting and stabbing diagnostic res41: Self-harm
TK60.00 Read Suicide and selfinflicted injury by cutting diagnostic res41: Self-harm
TK60100 Read Self inflicted lacerations to wrist diagnostic res41: Self-harm
TK60111 Read Slashed wrists self inflicted diagnostic res41: Self-harm
TK61.00 Read Suicide and selfinflicted injury by stabbing diagnostic res41: Self-harm
TK6z.00 Read Suicide and selfinflicted injury by cutting and stabbing NOS diagnostic res41: Self-harm
TK7..00 Read Suicide and selfinflicted injury by jumping from high place diagnostic res41: Self-harm
TK70.00 Read Suicide+selfinflicted injury-jump from residential premises diagnostic res41: Self-harm
TK71.00 Read Suicide+selfinflicted injury-jump from oth manmade structure diagnostic res41: Self-harm
TK72.00 Read Suicide+selfinflicted injury-jump from natural sites diagnostic res41: Self-harm
TK7z.00 Read Suicide+selfinflicted injury-jump from high place NOS diagnostic res41: Self-harm
TKx..00 Read Suicide and selfinflicted injury by other means diagnostic res41: Self-harm
TKx0.00 Read Suicide + selfinflicted injury-jump/lie before moving object diagnostic res41: Self-harm
TKx0000 Read Suicide + selfinflicted injury-jumping before moving object diagnostic res41: Self-harm
TKx1.00 Read Suicide and selfinflicted injury by burns or fire diagnostic res41: Self-harm
TKx2.00 Read Suicide and selfinflicted injury by scald diagnostic res41: Self-harm
TKx3.00 Read Suicide and selfinflicted injury by extremes of cold diagnostic res41: Self-harm
TKx4.00 Read Suicide and selfinflicted injury by electrocution diagnostic res41: Self-harm
TKx5.00 Read Suicide and selfinflicted injury by crashing motor vehicle diagnostic res41: Self-harm
TKx6.00 Read Suicide and selfinflicted injury by crashing of aircraft diagnostic res41: Self-harm
TKx7.00 Read Suicide and selfinflicted injury caustic subst, excl poison diagnostic res41: Self-harm
TKxy.00 Read Suicide and selfinflicted injury by other specified means diagnostic res41: Self-harm
TKxz.00 Read Suicide and selfinflicted injury by other means NOS diagnostic res41: Self-harm
TKy..00 Read Late effects of selfinflicted injury diagnostic res41: Self-harm
TKz..00 Read Suicide and selfinflicted injury NOS diagnostic res41: Self-harm
U2...00 Read [X]Intentional self-harm diagnostic res41: Self-harm
U20..00 Read [X]Intentional self poisoning/exposure to noxious substances diagnostic res41: Self-harm
U200.00 Read [X]Intent self poison/exposure to nonopioid analgesic diagnostic res41: Self-harm
U200000 Read [X]Int self poison/exposure to nonopioid analgesic at home diagnostic res41: Self-harm
U200100 Read [X]Intent self poison nonopioid analgesic at res institut diagnostic res41: Self-harm
U200.11 Read [X]Overdose - paracetamol diagnostic res41: Self-harm
U200.12 Read [X]Overdose - ibuprofen diagnostic res41: Self-harm
U200.13 Read [X]Overdose - aspirin diagnostic res41: Self-harm
U200400 Read [X]Intent self pois nonopioid analgesic in street/highway diagnostic res41: Self-harm
U200500 Read [X]Intent self pois nonopioid analgesic trade/service area diagnostic res41: Self-harm
U200y00 Read [X]Int self poison nonopioid analgesic other spec place diagnostic res41: Self-harm
U200z00 Read [X]Intent self poison nonopioid analgesic unspecif place diagnostic res41: Self-harm
U201.00 Read [X]Intent self poison/exposure to antiepileptic diagnostic res41: Self-harm
U201000 Read [X]Int self poison/exposure to antiepileptic at home diagnostic res41: Self-harm
U20..11 Read [X]Deliberate drug overdose / other poisoning diagnostic res41: Self-harm
U201z00 Read [X]Intent self poison antiepileptic unspecif place diagnostic res41: Self-harm
U202.00 Read [X]Intent self poison/exposure to sedative hypnotic diagnostic res41: Self-harm
U202000 Read [X]Int self poison/exposure to sedative hypnotic at home diagnostic res41: Self-harm
U202.11 Read [X]Overdose - sleeping tabs diagnostic res41: Self-harm
U202.12 Read [X]Overdose - diazepam diagnostic res41: Self-harm
U202.13 Read [X]Overdose - temazepam diagnostic res41: Self-harm
U202.15 Read [X]Overdose - nitrazepam diagnostic res41: Self-harm
U202.16 Read [X]Overdose - benzodiazepine diagnostic res41: Self-harm
U202.17 Read [X]Overdose - barbiturate diagnostic res41: Self-harm
U202.18 Read [X]Overdose - amobarbital diagnostic res41: Self-harm
U202400 Read [X]Intent self pois sedative hypnotic in street/highway diagnostic res41: Self-harm
U202y00 Read [X]Int self poison sedative hypnotic other spec place diagnostic res41: Self-harm
U202z00 Read [X]Intent self poison sedative hypnotic unspecif place diagnostic res41: Self-harm
U204.00 Read [X]Intent self poison/exposure to psychotropic drug diagnostic res41: Self-harm
U204000 Read [X]Int self poison/exposure to psychotropic drug at home diagnostic res41: Self-harm
U204100 Read [X]Intent self poison psychotropic drug at res institut diagnostic res41: Self-harm
U204.11 Read [X]Overdose - antidepressant diagnostic res41: Self-harm
U204.12 Read [X]Overdose - amitriptyline diagnostic res41: Self-harm
U204.13 Read [X]Overdose - SSRI diagnostic res41: Self-harm
U204y00 Read [X]Int self poison psychotropic drug other spec place diagnostic res41: Self-harm
U204z00 Read [X]Intent self poison psychotropic drug unspecif place diagnostic res41: Self-harm
U205.00 Read [X]Intent self poison/exposure to narcotic drug diagnostic res41: Self-harm
U205000 Read [X]Int self poison/exposure to narcotic drug at home diagnostic res41: Self-harm
U205y00 Read [X]Int self poison narcotic drug other spec place diagnostic res41: Self-harm
U205z00 Read [X]Intent self poison narcotic drug unspecif place diagnostic res41: Self-harm
U206.00 Read [X]Intent self poison/exposure to hallucinogen diagnostic res41: Self-harm
U206400 Read [X]Intent self pois hallucinogen in street/highway diagnostic res41: Self-harm
U207.00 Read [X]Intent self poison/exposure to oth autonomic drug diagnostic res41: Self-harm
U207000 Read [X]Int self poison/exposure to oth autonomic drug at home diagnostic res41: Self-harm
U207z00 Read [X]Intent self poison oth autonomic drug unspecif place diagnostic res41: Self-harm
U208.00 Read [X]Int self poison/exposure to other/unspec drug/medicament diagnostic res41: Self-harm
U208000 Read [X]Int self poison/exposure to oth/unsp drug/medicam home diagnostic res41: Self-harm
U208400 Read [X]Intent self pois oth/unsp drug/medic in street/highway diagnostic res41: Self-harm
U208y00 Read [X]Int self poison oth/unsp drug/medic other spec place diagnostic res41: Self-harm
U208z00 Read [X]Intent self poison oth/unsp drug/medic unspecif place diagnostic res41: Self-harm
U209.00 Read [X]Intent self poison/exposure to alcohol diagnostic res41: Self-harm
U209y00 Read [X]Int self poison alcohol other spec place diagnostic res41: Self-harm
U209z00 Read [X]Intent self poison alcohol unspecif place diagnostic res41: Self-harm
U20A.00 Read [X]Intentional self poison organ solvent,halogen hydrocarb diagnostic res41: Self-harm
U20A000 Read [X]Intent self pois organ solvent,halogen hydrocarb, home diagnostic res41: Self-harm
U20A.11 Read [X]Self poisoning from glue solvent diagnostic res41: Self-harm
U20A400 Read [X]Int self poison org solvent,halogen hydrocarb,in highway diagnostic res41: Self-harm
U20Az00 Read [X]Int self pois org solv,halogen hydrocarb, unspec place diagnostic res41: Self-harm
U20B.00 Read [X]Intent self poison/exposure to other gas/vapour diagnostic res41: Self-harm
U20B000 Read [X]Int self poison/exposure to other gas/vapour at home diagnostic res41: Self-harm
U20B.11 Read [X]Self carbon monoxide poisoning diagnostic res41: Self-harm
U20B200 Read [X]Int self poison other gas/vapour school/pub admin area diagnostic res41: Self-harm
U20By00 Read [X]Int self poison other gas/vapour other spec place diagnostic res41: Self-harm
U20Bz00 Read [X]Intent self poison other gas/vapour unspecif place diagnostic res41: Self-harm
U20C.00 Read [X]Intent self poison/exposure to pesticide diagnostic res41: Self-harm
U20C000 Read [X]Int self poison/exposure to pesticide at home diagnostic res41: Self-harm
U20C.11 Read [X]Self poisoning with weedkiller diagnostic res41: Self-harm
U20C.12 Read [X]Self poisoning with paraquat diagnostic res41: Self-harm
U20Cy00 Read [X]Int self poison pesticide other spec place diagnostic res41: Self-harm
U20y.00 Read [X]Intent self poison/exposure to unspecif chemical diagnostic res41: Self-harm
U20y000 Read [X]Int self poison/exposure to unspecif chemical at home diagnostic res41: Self-harm
U20y200 Read [X]Int self poison unspecif chemical school/pub admin area diagnostic res41: Self-harm
U20yz00 Read [X]Intent self poison unspecif chemical unspecif place diagnostic res41: Self-harm
U21..00 Read [X]Intent self harm by hanging strangulation / suffocation diagnostic res41: Self-harm
U210.00 Read [X]Intent self harm by hanging strangulat/suffocat occ home diagnostic res41: Self-harm
U2...11 Read [X]Self inflicted injury diagnostic res41: Self-harm
U211.00 Read [X]Intent self harm by hangng strangult/suffoct resid instit diagnostic res41: Self-harm
U2...12 Read [X]Injury - self-inflicted diagnostic res41: Self-harm
U212.00 Read [X]Inten slf harm hang strang/suffc sch oth ins/pub adm area diagnostic res41: Self-harm
U2...13 Read [X]Suicide diagnostic res41: Self-harm
U2...14 Read [X]Attempted suicide diagnostic res41: Self-harm
U2...15 Read [X]Para-suicide diagnostic res41: Self-harm
U216.00 Read [X]Intent self harm by hang strangl/suffc indust/constr area diagnostic res41: Self-harm
U21y.00 Read [X]Intent self harm by hangng strangul/suffoct oth spec plce diagnostic res41: Self-harm
U21z.00 Read [X]Intent self harm by hangng strangul/suffoct unspecif plce diagnostic res41: Self-harm
U22..00 Read [X]Intentional self harm by drowning and submersion diagnostic res41: Self-harm
U220.00 Read [X]Intent self harm by drowning/submersion occurrn at home diagnostic res41: Self-harm
U221.00 Read [X]Intent self harm by drowning/submersn occ resid instit'n diagnostic res41: Self-harm
U22y.00 Read [X]Intent self harm by drown/submersn occ oth specif place diagnostic res41: Self-harm
U22z.00 Read [X]Intent self harm by drown/submersn occ unspecified place diagnostic res41: Self-harm
U24..00 Read [X]Intent self harm by rifle shotgun/larger firearm disch diagnostic res41: Self-harm
U241.00 Read [X]Int self harm rifl s'gun/lrg frarm disch occ resid instit diagnostic res41: Self-harm
U242.00 Read [X]Int slf hrm rifl s'gun/lrg frarm dis sch/ins/pub adm area diagnostic res41: Self-harm
U25..00 Read [X]Intent self harm by other/unspecified firearm discharge diagnostic res41: Self-harm
U250.00 Read [X]Intent self harm oth/unspecif firearm disch occ at home diagnostic res41: Self-harm
U26..00 Read [X]Intentional self harm by explosive material diagnostic res41: Self-harm
U27..00 Read [X]Intentional self harm by smoke, fire and flames diagnostic res41: Self-harm
U270.00 Read [X]Intention self harm by smoke fire/flames occurrn at home diagnostic res41: Self-harm
U274.00 Read [X]Intent self harm by smoke fire/flame occ street/highway diagnostic res41: Self-harm
U27z.00 Read [X]Intent self harm by smoke fire/flames occ unspecif place diagnostic res41: Self-harm
U28..00 Read [X]Intentional self harm by steam hot vapours / hot objects diagnostic res41: Self-harm
U280.00 Read [X]Intent self harm by steam hot vapour/hot obj occ at home diagnostic res41: Self-harm
U28z.00 Read [X]Intent self harm by steam hot vapour/obj occ unspec place diagnostic res41: Self-harm
U29..00 Read [X]Intentional self harm by sharp object diagnostic res41: Self-harm
U290.00 Read [X]Intentional self harm by sharp object occurrence at home diagnostic res41: Self-harm
U291.00 Read [X]Intent self harm by sharp object occ resident instit'n diagnostic res41: Self-harm
U294.00 Read [X]Intention self harm by sharp object occ street/highway diagnostic res41: Self-harm
U29y.00 Read [X]Intention self harm by sharp object occ oth specif place diagnostic res41: Self-harm
U29z.00 Read [X]Intentional self harm by sharp object occ unspecif place diagnostic res41: Self-harm
U2A..00 Read [X]Intentional self harm by blunt object diagnostic res41: Self-harm
U2A0.00 Read [X]Intentional self harm by blunt object occurrence at home diagnostic res41: Self-harm
U2A1.00 Read [X]Intent self harm by blunt object occ resident instit'n diagnostic res41: Self-harm
U2A3.00 Read [X]Intent self harm by blunt object occ sports/athlet area diagnostic res41: Self-harm
U2B..00 Read [X]Intentional self harm by jumping from a high place diagnostic res41: Self-harm
U2B0.00 Read [X]Intent self harm by jumping from high place occ at home diagnostic res41: Self-harm
U2B4.00 Read [X]Intent self harm by jump from high place occ street/h'way diagnostic res41: Self-harm
U2B6.00 Read [X]Int self harm by jump from high place indust/constr area diagnostic res41: Self-harm
U2By.00 Read [X]Int self harm by jump from high place occ oth specif plce diagnostic res41: Self-harm
U2Bz.00 Read [X]Int self harm by jump from high place occ unspecif place diagnostic res41: Self-harm
U2C..00 Read [X]Intent self harm by jumping / lying before moving object diagnostic res41: Self-harm
U2C1.00 Read [X]Int self harm jump/lying befr mov obje occ resid instit'n diagnostic res41: Self-harm
U2C4.00 Read [X]Int self harm jump/lying befr mov obje occ street/highway diagnostic res41: Self-harm
U2Cy.00 Read [X]Int self harm jump/lying bef mov obje occ oth specif plce diagnostic res41: Self-harm
U2D..00 Read [X]Intentional self harm by crashing of motor vehicle diagnostic res41: Self-harm
U2D0.00 Read [X]Intent self harm by crash of motor vehicl occurrn at home diagnostic res41: Self-harm
U2D4.00 Read [X]Intent self harm by crash motor vehicl occ street/highway diagnostic res41: Self-harm
U2D6.00 Read [X]Intent self harm crash motor vehic occ indust/constr area diagnostic res41: Self-harm
U2E..00 Read [X]Self mutilation diagnostic res41: Self-harm
U2y..00 Read [X]Intentional self harm by other specified means diagnostic res41: Self-harm
U2y0.00 Read [X]Intentionl self harm by oth specif means occurrn at home diagnostic res41: Self-harm
U2y1.00 Read [X]Intent self harm by oth specif means occ resid instit'n diagnostic res41: Self-harm
U2yz.00 Read [X]Intent self harm by oth specif means occ unspecif place diagnostic res41: Self-harm
U2z..00 Read [X]Intentional self harm by unspecified means diagnostic res41: Self-harm
U2z0.00 Read [X]Intentional self harm by unspecif means occurrn at home diagnostic res41: Self-harm
U2z2.00 Read [X]Intent self harm by unspec mean occ sch/ins/pub adm area diagnostic res41: Self-harm
U2zy.00 Read [X]Intent self harm by unspecif means occ oth specif place diagnostic res41: Self-harm
U2zz.00 Read [X]Intent self harm by unspecif means occ at unspecif place diagnostic res41: Self-harm
U30..11 Read [X]Deliberate drug poisoning diagnostic res41: Self-harm
U41..00 Read [X]Hanging strangulation + suffocation undetermined intent diagnostic res41: Self-harm
U44..00 Read [X]Rifle shotgun+larger firearm discharge undetermin intent diagnostic res41: Self-harm
U45..00 Read [X]Other+unspecified firearm discharge undetermined intent diagnostic res41: Self-harm
U4B..00 Read [X]Falling jumping/pushed from high place undeterm intent diagnostic res41: Self-harm
U4Bz.00 Read [X]Fall jump/push frm high plce undt intnt occ unspecif plce diagnostic res41: Self-harm
U72..00 Read [X]Sequel intentn self-harm assault+event of undeterm intent diagnostic res41: Self-harm
U720.00 Read [X]Sequelae of intentional self-harm diagnostic res41: Self-harm
ZRLfC12 Read HoNOS item 2 - non-accidental self injury diagnostic res41: Self-harm
ZRn3.00 Read Suicide intent score subscale - attempt circumstances diagnostic res41: Self-harm
ZX...00 Read Self-harm diagnostic res41: Self-harm
ZX1..00 Read Self-injurious behaviour diagnostic res41: Self-harm
ZX...11 Read Self-damage diagnostic res41: Self-harm
ZX11.00 Read Biting self diagnostic res41: Self-harm
ZX11.11 Read Bites self diagnostic res41: Self-harm
ZX1..12 Read SIB - Self-injurious behaviour diagnostic res41: Self-harm
ZX1..13 Read Deliberate self-harm diagnostic res41: Self-harm
ZX12.00 Read Burning self diagnostic res41: Self-harm
ZX13.00 Read Cutting self diagnostic res41: Self-harm
ZX13100 Read Cutting own wrists diagnostic res41: Self-harm
ZX13.11 Read Cuts self diagnostic res41: Self-harm
ZX15.00 Read Drowning self diagnostic res41: Self-harm
ZX18.00 Read Hanging self diagnostic res41: Self-harm
ZX19.00 Read Hitting self diagnostic res41: Self-harm
ZX19100 Read Punching self diagnostic res41: Self-harm
ZX19200 Read Slapping self diagnostic res41: Self-harm
ZX1B.00 Read Jumping from height diagnostic res41: Self-harm
ZX1B100 Read Jumping from building diagnostic res41: Self-harm
ZX1B200 Read Jumping from bridge diagnostic res41: Self-harm
ZX1B300 Read Jumping from cliff diagnostic res41: Self-harm
ZX1C.00 Read Nipping self diagnostic res41: Self-harm
ZX1E.00 Read Pinching self diagnostic res41: Self-harm
ZX1G.00 Read Scratches self diagnostic res41: Self-harm
ZX1H.00 Read Self-asphyxiation diagnostic res41: Self-harm
ZX1H100 Read Self-strangulation diagnostic res41: Self-harm
ZX1H200 Read Self-suffocation diagnostic res41: Self-harm
ZX1I.00 Read Self-scalding diagnostic res41: Self-harm
ZX1J.00 Read Self-electrocution diagnostic res41: Self-harm
ZX1K.00 Read Self-incineration diagnostic res41: Self-harm
ZX1K.11 Read Setting fire to self diagnostic res41: Self-harm
ZX1K.12 Read Setting self alight diagnostic res41: Self-harm
ZX1L.00 Read Self-mutilation diagnostic res41: Self-harm
ZX1L100 Read Self-mutilation of hands diagnostic res41: Self-harm
ZX1L200 Read Self-mutilation of genitalia diagnostic res41: Self-harm
ZX1L300 Read Self-mutilation of penis diagnostic res41: Self-harm
ZX1L600 Read Self-mutilation of ears diagnostic res41: Self-harm
ZX1LD00 Read [X]Self mutilation diagnostic res41: Self-harm
ZX1M.00 Read Shooting self diagnostic res41: Self-harm
ZX1N.00 Read Stabbing self diagnostic res41: Self-harm
ZX1Q.00 Read Throwing self in front of train diagnostic res41: Self-harm
ZX1Q.11 Read Jumping under train diagnostic res41: Self-harm
ZX1R.00 Read Throwing self in front of vehicle diagnostic res41: Self-harm
ZX1S.00 Read Throwing self onto floor diagnostic res41: Self-harm

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