Risk of self-harm and suicide in people with specific psychiatric and physical disorders: comparisons between disorders using English national record linkage.

BACKGROUND: Psychiatric illnesses are known risk factors for self-harm but associations between self-harm and physical illnesses are less well established. We aimed to stratify selected chronic physical and psychiatric illnesses according to their relative risk of self-harm. DESIGN: Retrospective co...

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Main Authors: Singhal, A, Ross, J, Seminog, O, Hawton, K, Goldacre, M
Format: Journal article
Language:English
Published: Royal Society of Medicine Press Ltd 2014
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author Singhal, A
Ross, J
Seminog, O
Hawton, K
Goldacre, M
author_facet Singhal, A
Ross, J
Seminog, O
Hawton, K
Goldacre, M
author_sort Singhal, A
collection OXFORD
description BACKGROUND: Psychiatric illnesses are known risk factors for self-harm but associations between self-harm and physical illnesses are less well established. We aimed to stratify selected chronic physical and psychiatric illnesses according to their relative risk of self-harm. DESIGN: Retrospective cohort studies using a linked dataset of Hospital Episode Statistics (HES) for 1999-2011. PARTICIPANTS: Individuals with selected psychiatric or physical conditions were compared with a reference cohort constructed from patients admitted for a variety of other conditions and procedures. SETTING: All admissions and day cases in National Health Service (NHS) hospitals in England. MAIN OUTCOME MEASURES: Hospital episodes of self-harm. Rate ratios (RRs) were derived by comparing admission for self-harm between cohorts. RESULTS: The psychiatric illnesses studied (depression, bipolar disorder, alcohol abuse, anxiety disorders, eating disorders, schizophrenia and substance abuse) all had very high RRs (> 5) for self-harm. Of the physical illnesses studied, an increased risk of self-harm was associated with epilepsy (RR = 2.9, 95% confidence interval [CI] 2.8-2.9), asthma (1.8, 1.8-1.9), migraine (1.8, 1.7-1.8), psoriasis (1.6, 1.5-1.7), diabetes mellitus (1.6, 1.5-1.6), eczema (1.4, 1.3-1.5) and inflammatory polyarthropathies (1.4, 1.3-1.4). RRs were significantly low for cancers (0.95, 0.93-0.97), congenital heart disease (0.9, 0.8-0.9), ulcerative colitis (0.8, 0.7-0.8), sickle cell anaemia (0.7, 0.6-0.8) and Down's syndrome (0.1, 0.1-0.2). CONCLUSIONS: Psychiatric illnesses carry a greatly increased risk of self-harm as well as of suicide. Many chronic physical illnesses are also associated with an increased risk of both self-harm and suicide. Identifying those at risk will allow provision of appropriate monitoring and support.
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spelling oxford-uuid:2be70ad4-afa7-4b54-98ab-71c3232c62672022-03-26T12:33:46ZRisk of self-harm and suicide in people with specific psychiatric and physical disorders: comparisons between disorders using English national record linkage.Journal articlehttp://purl.org/coar/resource_type/c_dcae04bcuuid:2be70ad4-afa7-4b54-98ab-71c3232c6267EnglishSymplectic Elements at OxfordRoyal Society of Medicine Press Ltd2014Singhal, ARoss, JSeminog, OHawton, KGoldacre, MBACKGROUND: Psychiatric illnesses are known risk factors for self-harm but associations between self-harm and physical illnesses are less well established. We aimed to stratify selected chronic physical and psychiatric illnesses according to their relative risk of self-harm. DESIGN: Retrospective cohort studies using a linked dataset of Hospital Episode Statistics (HES) for 1999-2011. PARTICIPANTS: Individuals with selected psychiatric or physical conditions were compared with a reference cohort constructed from patients admitted for a variety of other conditions and procedures. SETTING: All admissions and day cases in National Health Service (NHS) hospitals in England. MAIN OUTCOME MEASURES: Hospital episodes of self-harm. Rate ratios (RRs) were derived by comparing admission for self-harm between cohorts. RESULTS: The psychiatric illnesses studied (depression, bipolar disorder, alcohol abuse, anxiety disorders, eating disorders, schizophrenia and substance abuse) all had very high RRs (> 5) for self-harm. Of the physical illnesses studied, an increased risk of self-harm was associated with epilepsy (RR = 2.9, 95% confidence interval [CI] 2.8-2.9), asthma (1.8, 1.8-1.9), migraine (1.8, 1.7-1.8), psoriasis (1.6, 1.5-1.7), diabetes mellitus (1.6, 1.5-1.6), eczema (1.4, 1.3-1.5) and inflammatory polyarthropathies (1.4, 1.3-1.4). RRs were significantly low for cancers (0.95, 0.93-0.97), congenital heart disease (0.9, 0.8-0.9), ulcerative colitis (0.8, 0.7-0.8), sickle cell anaemia (0.7, 0.6-0.8) and Down's syndrome (0.1, 0.1-0.2). CONCLUSIONS: Psychiatric illnesses carry a greatly increased risk of self-harm as well as of suicide. Many chronic physical illnesses are also associated with an increased risk of both self-harm and suicide. Identifying those at risk will allow provision of appropriate monitoring and support.
spellingShingle Singhal, A
Ross, J
Seminog, O
Hawton, K
Goldacre, M
Risk of self-harm and suicide in people with specific psychiatric and physical disorders: comparisons between disorders using English national record linkage.
title Risk of self-harm and suicide in people with specific psychiatric and physical disorders: comparisons between disorders using English national record linkage.
title_full Risk of self-harm and suicide in people with specific psychiatric and physical disorders: comparisons between disorders using English national record linkage.
title_fullStr Risk of self-harm and suicide in people with specific psychiatric and physical disorders: comparisons between disorders using English national record linkage.
title_full_unstemmed Risk of self-harm and suicide in people with specific psychiatric and physical disorders: comparisons between disorders using English national record linkage.
title_short Risk of self-harm and suicide in people with specific psychiatric and physical disorders: comparisons between disorders using English national record linkage.
title_sort risk of self harm and suicide in people with specific psychiatric and physical disorders comparisons between disorders using english national record linkage
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