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Premature death after self-harm: a multicentre cohort study.

Helen Bergen1, Keith Hawton, Keith Waters

  • 1University of Oxford Centre for Suicide Research, Department of Psychiatry, Warneford Hospital, Headington, Oxford, UK.

Lancet (London, England)
|September 22, 2012
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Summary

Individuals who self-harm face significantly higher risks of premature death, particularly from natural causes, with increased mortality linked to socioeconomic deprivation. This highlights the critical need to address physical health in self-harm patient management.

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Area of Science:

  • Public Health
  • Epidemiology
  • Clinical Medicine

Background:

  • Self-harm is associated with an elevated risk of premature mortality.
  • Understanding cause-specific mortality and its link to socioeconomic factors in self-harm patients is crucial.

Purpose of the Study:

  • To investigate cause-specific premature death in individuals who self-harm.
  • To examine the association between socioeconomic deprivation and mortality in this population.

Main Methods:

  • A cohort study was conducted on patients presenting with self-harm to UK emergency departments (2000-2007).
  • Socioeconomic status was assessed using postcodes linked to the Index of Multiple Deprivation.
  • Mortality data were collected up to 2009, with analysis of age-standardized mortality ratios (SMRs) and years of life lost (YLL).

Main Results:

  • The study included 30,950 individuals, with 6.1% dying during follow-up.
  • Mortality was significantly higher in self-harm patients (SMR 3.6) compared to the general population, especially in males.
  • Deaths from natural causes were 2.5 to 7.5 times more frequent than expected, with circulatory and digestive diseases being major contributors.
  • All-cause mortality and natural-cause mortality significantly increased with higher levels of socioeconomic deprivation.

Conclusions:

  • Physical health and life expectancy are substantially reduced in individuals who self-harm.
  • Clinical management of self-harm should integrate assessment of physical health needs alongside psychosocial issues.