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Mental illness and suicide after self-harm among young adults: long-term follow-up of self-harm patients, admitted to hospital care, in a national cohort.

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Title: Mental illness and suicide after self-harm among young adults: long-term follow-up of self-harm patients, admitted to hospital care, in a national cohort.
Authors: Beckman, K., Mittendorfer-Rutz, E., Lichtenstein, P., Larsson, H., Almqvist, C., Runeson, B., Dahlin, M.
Source: Psychological Medicine. Dec2016, Vol. 46 Issue 16, p3397-3405. 9p.
Subjects: Mental illness risk factors, Suicide prevention, Suicide risk factors, Psychiatric drugs, Self-injurious behavior, Antidepressants, Confidence intervals, Hospital care, Hospital admission & discharge, Longitudinal method, Patients, Tranquilizing drugs, Treatment effectiveness, Family history (Medicine), Adults, Prognosis
Abstract: BackgroundSelf-harm among young adults is a common and increasing phenomenon in many parts of the world. The long-term prognosis after self-harm at young age is inadequately known. We aimed to estimate the risk of mental illness and suicide in adult life after self-harm in young adulthood and to identify prognostic factors for adverse outcome.MethodWe conducted a national population-based matched case-cohort study. Patients aged 18-24 years (n = 13 731) hospitalized after self-harm between 1990 and 2003 and unexposed individuals of the same age (n = 137 310 ) were followed until December 2009. Outcomes were suicide, psychiatric hospitalization and psychotropic medication in short-term (1-5 years) and long-term (>5 years) follow-up.ResultsSelf-harm implied an increased relative risk of suicide during follow-up [hazard ratio (HR) 16.4, 95% confidence interval (CI) 12.9–20.9). At long-term follow-up, 20.3% had psychiatric hospitalizations and 51.1% psychotropic medications, most commonly antidepressants and anxiolytics. There was a six-fold risk of psychiatric hospitalization (HR 6.3, 95% CI 5.8–6.8) and almost three-fold risk of psychotropic medication (HR 2.8, 95% CI 2.7–3.0) in long-term follow-up. Mental disorder at baseline, especially a psychotic disorder, and a family history of suicide were associated with adverse outcome among self-harm patients.ConclusionWe found highly increased risks of future mental illness and suicide among young adults after self-harm. A history of a mental disorder was an important indicator of long-term adverse outcome. Clinicians should consider the substantially increased risk of suicide among self-harm patients with psychotic disorders. [ABSTRACT FROM PUBLISHER]
Copyright of Psychological Medicine is the property of Cambridge University Press and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
Database: Psychology and Behavioral Sciences Collection
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  Data: Mental illness and suicide after self-harm among young adults: long-term follow-up of self-harm patients, admitted to hospital care, in a national cohort.
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  Data: <searchLink fieldCode="AR" term="%22Beckman%2C+K%2E%22">Beckman, K.</searchLink><br /><searchLink fieldCode="AR" term="%22Mittendorfer-Rutz%2C+E%2E%22">Mittendorfer-Rutz, E.</searchLink><br /><searchLink fieldCode="AR" term="%22Lichtenstein%2C+P%2E%22">Lichtenstein, P.</searchLink><br /><searchLink fieldCode="AR" term="%22Larsson%2C+H%2E%22">Larsson, H.</searchLink><br /><searchLink fieldCode="AR" term="%22Almqvist%2C+C%2E%22">Almqvist, C.</searchLink><br /><searchLink fieldCode="AR" term="%22Runeson%2C+B%2E%22">Runeson, B.</searchLink><br /><searchLink fieldCode="AR" term="%22Dahlin%2C+M%2E%22">Dahlin, M.</searchLink>
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  Data: <searchLink fieldCode="JN" term="%22Psychological+Medicine%22">Psychological Medicine</searchLink>. Dec2016, Vol. 46 Issue 16, p3397-3405. 9p.
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  Data: <searchLink fieldCode="DE" term="%22Mental+illness+risk+factors%22">Mental illness risk factors</searchLink><br /><searchLink fieldCode="DE" term="%22Suicide+prevention%22">Suicide prevention</searchLink><br /><searchLink fieldCode="DE" term="%22Suicide+risk+factors%22">Suicide risk factors</searchLink><br /><searchLink fieldCode="DE" term="%22Psychiatric+drugs%22">Psychiatric drugs</searchLink><br /><searchLink fieldCode="DE" term="%22Self-injurious+behavior%22">Self-injurious behavior</searchLink><br /><searchLink fieldCode="DE" term="%22Antidepressants%22">Antidepressants</searchLink><br /><searchLink fieldCode="DE" term="%22Confidence+intervals%22">Confidence intervals</searchLink><br /><searchLink fieldCode="DE" term="%22Hospital+care%22">Hospital care</searchLink><br /><searchLink fieldCode="DE" term="%22Hospital+admission+%26+discharge%22">Hospital admission & discharge</searchLink><br /><searchLink fieldCode="DE" term="%22Longitudinal+method%22">Longitudinal method</searchLink><br /><searchLink fieldCode="DE" term="%22Patients%22">Patients</searchLink><br /><searchLink fieldCode="DE" term="%22Tranquilizing+drugs%22">Tranquilizing drugs</searchLink><br /><searchLink fieldCode="DE" term="%22Treatment+effectiveness%22">Treatment effectiveness</searchLink><br /><searchLink fieldCode="DE" term="%22Family+history+%28Medicine%29%22">Family history (Medicine)</searchLink><br /><searchLink fieldCode="DE" term="%22Adults%22">Adults</searchLink><br /><searchLink fieldCode="DE" term="%22Prognosis%22">Prognosis</searchLink>
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  Data: BackgroundSelf-harm among young adults is a common and increasing phenomenon in many parts of the world. The long-term prognosis after self-harm at young age is inadequately known. We aimed to estimate the risk of mental illness and suicide in adult life after self-harm in young adulthood and to identify prognostic factors for adverse outcome.MethodWe conducted a national population-based matched case-cohort study. Patients aged 18-24 years (n = 13 731) hospitalized after self-harm between 1990 and 2003 and unexposed individuals of the same age (n = 137 310 ) were followed until December 2009. Outcomes were suicide, psychiatric hospitalization and psychotropic medication in short-term (1-5 years) and long-term (>5 years) follow-up.ResultsSelf-harm implied an increased relative risk of suicide during follow-up [hazard ratio (HR) 16.4, 95% confidence interval (CI) 12.9–20.9). At long-term follow-up, 20.3% had psychiatric hospitalizations and 51.1% psychotropic medications, most commonly antidepressants and anxiolytics. There was a six-fold risk of psychiatric hospitalization (HR 6.3, 95% CI 5.8–6.8) and almost three-fold risk of psychotropic medication (HR 2.8, 95% CI 2.7–3.0) in long-term follow-up. Mental disorder at baseline, especially a psychotic disorder, and a family history of suicide were associated with adverse outcome among self-harm patients.ConclusionWe found highly increased risks of future mental illness and suicide among young adults after self-harm. A history of a mental disorder was an important indicator of long-term adverse outcome. Clinicians should consider the substantially increased risk of suicide among self-harm patients with psychotic disorders. [ABSTRACT FROM PUBLISHER]
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  Data: <i>Copyright of Psychological Medicine is the property of Cambridge University Press and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract.</i> (Copyright applies to all Abstracts.)
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        Value: 10.1017/S0033291716002282
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        Text: English
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        Type: general
      – SubjectFull: Suicide prevention
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      – SubjectFull: Suicide risk factors
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              Text: Dec2016
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