What are the sociodemographic and gender determinants of non-fatal self-harm in older adult users and non-users of antidepressants? A national population-based study
Abstract Background Late-life self-harm (SH) is often linked to depression. However, very few studies have explored the role of other factors and their interaction with depression in the occurrence of late-life SH. The objective of this research was to examine sociodemographic and gender factors ass...
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| Format: | Article |
| Language: | English |
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BMC
2020-06-01
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| Series: | BMC Public Health |
| Subjects: | |
| Online Access: | http://link.springer.com/article/10.1186/s12889-020-08892-2 |
| _version_ | 1818188533119057920 |
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| author | Khedidja Hedna Johan Fastbom Ingmar Skoog Gunnel Hensing Margda Waern |
| author_facet | Khedidja Hedna Johan Fastbom Ingmar Skoog Gunnel Hensing Margda Waern |
| author_sort | Khedidja Hedna |
| collection | DOAJ |
| description | Abstract Background Late-life self-harm (SH) is often linked to depression. However, very few studies have explored the role of other factors and their interaction with depression in the occurrence of late-life SH. The objective of this research was to examine sociodemographic and gender factors associated with non-fatal SH, in older adults with and without antidepressant therapy. Methods We used national longitudinal register data from a total cohort of all Swedish residents aged ≥75 years between 2006 and 2014 (N = 1,413,806). Using personal identity numbers, we linked individuals’ data from numerous national registers. We identified all those with at least one episode of non-fatal self-harm (regardless of level of intent to die) and matched 50 controls to each case. A nested case–control design was used to investigate sociodemographic factors associated with non-fatal SH in the total cohort and among antidepressant users and non-users. Risk factors were analysed in adjusted conditional logistic regression models for the entire cohort and by gender. Results In all, 2242 individuals had at least one episode of a non-fatal SH (980 men and 1262 women). Being unmarried was a risk factor for non-fatal SH in men but not in women. Among users of antidepressants, higher non-fatal SH risk was observed in those born outside the Nordic countries (IRR: 1.44; 95% CI: 1.11–1.86), whereas in AD non-users increased risk was seen in those from Nordic countries other than Sweden (IRR: 1.58; 95% CI: 1.08–2.29). Antidepressant users with higher education had an increased risk of non-fatal SH (IRR: 1.34; 95% CI: 1.12–1.61), in both men and women. Conclusions Foreign country of birth was associated with increased risk for non-fatal SH in older adults with and without AD therapies. Being married was a protective factor for non-fatal SH in men. The complex association between sociodemographic factors and use of antidepressants in the occurrence of self-harm in older men and women indicates the need for multifaceted tailored preventive strategies including healthcare and social services alike. |
| first_indexed | 2024-12-11T23:28:26Z |
| format | Article |
| id | doaj.art-aad206c92395426f847818d501d39496 |
| institution | Directory Open Access Journal |
| issn | 1471-2458 |
| language | English |
| last_indexed | 2024-12-11T23:28:26Z |
| publishDate | 2020-06-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Public Health |
| spelling | doaj.art-aad206c92395426f847818d501d394962022-12-22T00:46:08ZengBMCBMC Public Health1471-24582020-06-012011810.1186/s12889-020-08892-2What are the sociodemographic and gender determinants of non-fatal self-harm in older adult users and non-users of antidepressants? A national population-based studyKhedidja Hedna0Johan Fastbom1Ingmar Skoog2Gunnel Hensing3Margda Waern4Center for Ageing and Health (Age Cap), Department of Psychiatry and Neurochemistry, Gothenburg UniversityAging Research Center, Karolinska Institutet and Stockholm UniversityCenter for Ageing and Health (Age Cap), Department of Psychiatry and Neurochemistry, Gothenburg UniversitySection of Epidemiology and Social Medicine, Department of Public Health and Community Medicine at Institute of Medicine, University of GothenburgCenter for Ageing and Health (Age Cap), Department of Psychiatry and Neurochemistry, Gothenburg UniversityAbstract Background Late-life self-harm (SH) is often linked to depression. However, very few studies have explored the role of other factors and their interaction with depression in the occurrence of late-life SH. The objective of this research was to examine sociodemographic and gender factors associated with non-fatal SH, in older adults with and without antidepressant therapy. Methods We used national longitudinal register data from a total cohort of all Swedish residents aged ≥75 years between 2006 and 2014 (N = 1,413,806). Using personal identity numbers, we linked individuals’ data from numerous national registers. We identified all those with at least one episode of non-fatal self-harm (regardless of level of intent to die) and matched 50 controls to each case. A nested case–control design was used to investigate sociodemographic factors associated with non-fatal SH in the total cohort and among antidepressant users and non-users. Risk factors were analysed in adjusted conditional logistic regression models for the entire cohort and by gender. Results In all, 2242 individuals had at least one episode of a non-fatal SH (980 men and 1262 women). Being unmarried was a risk factor for non-fatal SH in men but not in women. Among users of antidepressants, higher non-fatal SH risk was observed in those born outside the Nordic countries (IRR: 1.44; 95% CI: 1.11–1.86), whereas in AD non-users increased risk was seen in those from Nordic countries other than Sweden (IRR: 1.58; 95% CI: 1.08–2.29). Antidepressant users with higher education had an increased risk of non-fatal SH (IRR: 1.34; 95% CI: 1.12–1.61), in both men and women. Conclusions Foreign country of birth was associated with increased risk for non-fatal SH in older adults with and without AD therapies. Being married was a protective factor for non-fatal SH in men. The complex association between sociodemographic factors and use of antidepressants in the occurrence of self-harm in older men and women indicates the need for multifaceted tailored preventive strategies including healthcare and social services alike.http://link.springer.com/article/10.1186/s12889-020-08892-2PharmacoepidemiologySociodemographic factorsSelf-harmCohort studyOlder adultsAntidepressants |
| spellingShingle | Khedidja Hedna Johan Fastbom Ingmar Skoog Gunnel Hensing Margda Waern What are the sociodemographic and gender determinants of non-fatal self-harm in older adult users and non-users of antidepressants? A national population-based study BMC Public Health Pharmacoepidemiology Sociodemographic factors Self-harm Cohort study Older adults Antidepressants |
| title | What are the sociodemographic and gender determinants of non-fatal self-harm in older adult users and non-users of antidepressants? A national population-based study |
| title_full | What are the sociodemographic and gender determinants of non-fatal self-harm in older adult users and non-users of antidepressants? A national population-based study |
| title_fullStr | What are the sociodemographic and gender determinants of non-fatal self-harm in older adult users and non-users of antidepressants? A national population-based study |
| title_full_unstemmed | What are the sociodemographic and gender determinants of non-fatal self-harm in older adult users and non-users of antidepressants? A national population-based study |
| title_short | What are the sociodemographic and gender determinants of non-fatal self-harm in older adult users and non-users of antidepressants? A national population-based study |
| title_sort | what are the sociodemographic and gender determinants of non fatal self harm in older adult users and non users of antidepressants a national population based study |
| topic | Pharmacoepidemiology Sociodemographic factors Self-harm Cohort study Older adults Antidepressants |
| url | http://link.springer.com/article/10.1186/s12889-020-08892-2 |
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