{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,27]],"date-time":"2026-10-27T09:46:56Z","timestamp":1793094416937,"version":"4.5.0"},"reference-count":43,"publisher":"Hogrefe Publishing Group","issue":"4","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Crisis"],"published-print":{"date-parts":[[2026,7]]},"abstract":"<jats:p>Abstract: Background: In Brazil, national surveillance indicates a rise in self-harm, but little is known about patterns of repeated presentations to healthcare services or changes in self-harm methods over time. Aims: To examine sociodemographic and clinical factors associated with two or more (repeated) presentations to healthcare services for self-harm, and to explore method switching among individuals presenting to healthcare services in Vit\u00f3ria, Brazil. Method: A retrospective cohort analysis was conducted using administrative data from the Brazilian Unified Health System in Vitoria City (Esp\u00edrito Santo; 2012\u20132022). Records from the Notifiable Diseases Information System and e-SUS National Health Surveillance System were used to identify individuals with self-harm presentations. Modified Poisson Regression was employed to examine associations between repeated self-harm episodes and sociodemographic and clinical characteristics between 2018 and 2022. Results: Among 2,152 self-harm notifications, 69% involved repeated presentations. The results revealed that female sex [RR = 1.14, 95% CI: 1.06\u20131.23], presence of disorder [RR = 1.41, 95% CI: 1.27\u20131.57], and use of sharp objects [RR = 1.22, 95% CI: 1.12\u20131.32] were positively associated with repetition, whereas Black [RR = 0.87, 95% CI: 0.79\u20130.95], multiracial ethnicity [RR = 0.92, 95% CI: 0.87\u20130.98], and poisoning [RR = 0.92, 95% CI: 0.85\u20131.00] were negatively associated. Among those with multiple episodes, half re-presented within 77 days and three-quarters within 260 days. Method switching was common: 42% changed methods between their first and second episodes, with cutting most frequently transitioning to self-poisoning. Limitations: Findings rely on routine notification data, which vary in completeness. Some clinical information was based on collateral reports rather than diagnosis. Conclusion: Repeated self-harm presentations often occur within short intervals. High levels of method switching underscore the need for person-centered assessments.<\/jats:p>","DOI":"10.1027\/0227-5910\/a001066","type":"journal-article","created":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T07:06:56Z","timestamp":1782889616000},"page":"260-271","source":"Crossref","is-referenced-by-count":1,"title":["Epidemiological Profile of Repeated Self-Harm Presentations to Healthcare Services in a Brazilian Urban Centre (Vitoria, ES)"],"prefix":"10.1027","volume":"47","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7394-0293","authenticated-orcid":true,"given":"Katerina","family":"Kavalidou","sequence":"first","affiliation":[{"name":"National Suicide Research Foundation, WHO Collaborating Centre for Surveillance and Research in Suicide Prevention, University College Cork, Cork, Ireland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5710-7250","authenticated-orcid":true,"given":"Renata Martins","family":"Predo","sequence":"additional","affiliation":[{"name":"Institute of Economics, State University of Campinas (UNICAMP), Campinas, S\u00e3o Paulo, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5034-6454","authenticated-orcid":true,"given":"V\u00edtor Fabri","family":"de Oliveira","sequence":"additional","affiliation":[{"name":"Institute of Economics, State University of Campinas (UNICAMP), Campinas, S\u00e3o Paulo, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7188-9650","authenticated-orcid":true,"given":"Alexandra","family":"Iglesias","sequence":"additional","affiliation":[{"name":"Department of Psychology, Federal University of Esp\u00edrito Santo, Esp\u00edrito Santo, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5000-2915","authenticated-orcid":true,"given":"Magda Diniz","family":"Dimenstein","sequence":"additional","affiliation":[{"name":"Graduate Program in Psychology, Federal University of Rio Grande do Norte, Rio Grande do Norte, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-8800-2047","authenticated-orcid":true,"given":"Ra\u00edsa Catherinne Cagliari","family":"Costa","sequence":"additional","affiliation":[{"name":"Department of Psychology, Federal University of Esp\u00edrito Santo, Esp\u00edrito Santo, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8451-0555","authenticated-orcid":true,"given":"Tiago C.","family":"Zortea","sequence":"additional","affiliation":[{"name":"Emergency Department Psychiatric Service, Oxford Health NHS Foundation Trust, Oxford, UK"},{"name":"Suicidal Behaviour Research Laboratory, Institute of Health and Wellbeing, University of Glasgow, Glasgow, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"101","reference":[{"key":"c1","doi-asserted-by":"publisher","DOI":"10.1016\/j.lana.2024.100691"},{"key":"c2","volume-title":"Injury in Australia: Hospitalisations","author":"Australian Institute of Health and Welfare.","year":"2025"},{"key":"c3","doi-asserted-by":"publisher","DOI":"10.1590\/1413-812320212611.3.48952020"},{"key":"c4","doi-asserted-by":"publisher","DOI":"10.1016\/j.jad.2010.05.001"},{"key":"c5","doi-asserted-by":"publisher","DOI":"10.1192\/bjp.bp.109.072637"},{"key":"c6","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0309505"},{"key":"c7","doi-asserted-by":"publisher","DOI":"10.1186\/s12889-022-13455-8"},{"key":"c8","doi-asserted-by":"publisher","DOI":"10.20435\/pssa.v14i3.2005"},{"key":"c9","doi-asserted-by":"publisher","DOI":"10.2307\/2290467"},{"key":"c10","doi-asserted-by":"publisher","DOI":"10.1016\/j.jad.2020.01.093"},{"key":"c11","doi-asserted-by":"publisher","DOI":"10.1016\/S2215-0366(19)30402-X"},{"key":"c12","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2015-010538"},{"key":"c13","doi-asserted-by":"publisher","DOI":"10.1590\/1414-462X201800030075"},{"key":"c14","doi-asserted-by":"publisher","DOI":"10.3390\/diagnostics12112851"},{"key":"c15","doi-asserted-by":"publisher","DOI":"10.1038\/s44220-023-00153-6"},{"key":"c16","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0314294"},{"key":"c500","doi-asserted-by":"publisher","DOI":"10.1383\/medc.32.8.38.43174"},{"key":"c17","doi-asserted-by":"publisher","DOI":"10.1017\/S0033291703007943"},{"key":"c18","doi-asserted-by":"publisher","DOI":"10.1016\/S2215-0366(22)00232-2"},{"key":"c19","doi-asserted-by":"publisher","DOI":"10.1016\/S2215-0366(16)30070-0"},{"key":"c20","volume-title":"National clinical programme for self-harm and suicide-related ideation","author":"Health Service Executive. 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