The changing gender ratio in occurrence of deliberate self-harm across the lifecycle

Background: Overall gender ratios are often quoted in studies of deliberate self-harm (DSH) patients, almost always with higher rates in females than males. Reporting a ratio across all ages may conceal important variations in the gender ratio across the life cycle. Method: Analysis was done of the gender ratio by age groups in rates of DSH in a consecutive sample of DSH patients presenting to a general hospital over a 10-year period. The patients were identified through a well-established monitoring system. Results: The study sample included 2,189 female and 1,439 male patients. While the overall gender rate ratio was 1.5 females to each male, the ratio varied considerably by age group: 8:1 in 10-14-year-olds, 3.1:1 in 15-19-year-olds, 1.6:1 in 20-24-year-olds, approximately 1.3:1 in 25-49-year-olds, and 0.8:1 in people aged 50 years and over. Conclusion: Statements about overall gender ratios for DSH conceal important changes in the ratio across the life cycle. These changes probably reflect differences in development and problems faced in adolescence, changes in motivation for DSH with age, and the closer resemblance of DSH to suicide in older age groups.