Association between SARS-CoV-2 infection and self-harm: Danish nationwide register-based cohort study

<p><strong>Background:&nbsp;</strong>Case studies have linked SARS-CoV-2 infection to suicidal behaviour. However, conclusive evidence is lacking.</p> <p><strong>Aims:&nbsp;</strong>To examine whether a history of SARS-CoV-2 infection or SARS-CoV-2-r...

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Main Authors: Erlangsen, A, Qin, P, Madsen, T, Hawton, K, Hjorthøj, C, Molbak, K, Laursen, TM, Nordentoft, M, Nilsson, SF
Format: Journal article
Language:English
Published: Cambridge University Press 2023
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author Erlangsen, A
Qin, P
Madsen, T
Hawton, K
Hjorthøj, C
Molbak, K
Laursen, TM
Nordentoft, M
Nilsson, SF
author_facet Erlangsen, A
Qin, P
Madsen, T
Hawton, K
Hjorthøj, C
Molbak, K
Laursen, TM
Nordentoft, M
Nilsson, SF
author_sort Erlangsen, A
collection OXFORD
description <p><strong>Background:&nbsp;</strong>Case studies have linked SARS-CoV-2 infection to suicidal behaviour. However, conclusive evidence is lacking.</p> <p><strong>Aims:&nbsp;</strong>To examine whether a history of SARS-CoV-2 infection or SARS-CoV-2-related hospital admission was associated with self-harm in the general population and in high-risk groups.</p> <p><strong>Method:&nbsp;</strong>A cohort design was applied to nationwide data on all people aged &ge;15 years and living in Denmark between 27 February 2020 and 15 October 2021. Exposure was identified as having had a positive SARS-CoV-2 PCR test, and further assessed as SARS-CoV-2-related hospital admission. Rates of probable self-harm were examined using adjusted incidence rate ratios (aIRRs). The following subgroups were identified: (a) lower educational level, (b) chronic medical conditions, (c) disability pension, (d) mental disorders, (e) substance use disorders, and history of (f) homelessness and (g) imprisonment.</p> <p><strong>Results:&nbsp;</strong>Among 4 412 248 included individuals, 260 663 (5.9%) had tested positive for SARS-CoV-2. Out of 5453 individuals presenting with self-harm, 131 (2.4%) had been infected. Individuals with a history of a positive SARS-CoV-2 test result had an aIRR for self-harm of 0.86 (95% CI 0.72&ndash;1.03) compared with those without. High rates were found after a SARS-CoV-2-related hospital admission (aIRR = 7.68; 95% CI 5.61&ndash;10.51) or a non-SARS-CoV-2-related admission (aIRR = 10.27; 95% CI 9.65&ndash;10.93) versus non-infected and not admitted. In sensitivity analyses with a more restrictive definition of self-harm, a positive PCR test was associated with lower rates of self-harm.</p> <p><strong>Conclusions:&nbsp;</strong>Individuals with a PCR-confirmed SARS-CoV-2 infection did not have higher rates of self-harm than those without. Hospital admission in general, rather than being SARS-CoV-2 positive. seemed to be linked to elevated rates of self-harm.</p>
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spelling oxford-uuid:5ff2017c-f971-402e-8741-961aa6a8f54b2023-07-13T08:47:06ZAssociation between SARS-CoV-2 infection and self-harm: Danish nationwide register-based cohort studyJournal articlehttp://purl.org/coar/resource_type/c_dcae04bcuuid:5ff2017c-f971-402e-8741-961aa6a8f54bEnglishSymplectic ElementsCambridge University Press2023Erlangsen, AQin, PMadsen, THawton, KHjorthøj, CMolbak, KLaursen, TMNordentoft, MNilsson, SF<p><strong>Background:&nbsp;</strong>Case studies have linked SARS-CoV-2 infection to suicidal behaviour. However, conclusive evidence is lacking.</p> <p><strong>Aims:&nbsp;</strong>To examine whether a history of SARS-CoV-2 infection or SARS-CoV-2-related hospital admission was associated with self-harm in the general population and in high-risk groups.</p> <p><strong>Method:&nbsp;</strong>A cohort design was applied to nationwide data on all people aged &ge;15 years and living in Denmark between 27 February 2020 and 15 October 2021. Exposure was identified as having had a positive SARS-CoV-2 PCR test, and further assessed as SARS-CoV-2-related hospital admission. Rates of probable self-harm were examined using adjusted incidence rate ratios (aIRRs). The following subgroups were identified: (a) lower educational level, (b) chronic medical conditions, (c) disability pension, (d) mental disorders, (e) substance use disorders, and history of (f) homelessness and (g) imprisonment.</p> <p><strong>Results:&nbsp;</strong>Among 4 412 248 included individuals, 260 663 (5.9%) had tested positive for SARS-CoV-2. Out of 5453 individuals presenting with self-harm, 131 (2.4%) had been infected. Individuals with a history of a positive SARS-CoV-2 test result had an aIRR for self-harm of 0.86 (95% CI 0.72&ndash;1.03) compared with those without. High rates were found after a SARS-CoV-2-related hospital admission (aIRR = 7.68; 95% CI 5.61&ndash;10.51) or a non-SARS-CoV-2-related admission (aIRR = 10.27; 95% CI 9.65&ndash;10.93) versus non-infected and not admitted. In sensitivity analyses with a more restrictive definition of self-harm, a positive PCR test was associated with lower rates of self-harm.</p> <p><strong>Conclusions:&nbsp;</strong>Individuals with a PCR-confirmed SARS-CoV-2 infection did not have higher rates of self-harm than those without. Hospital admission in general, rather than being SARS-CoV-2 positive. seemed to be linked to elevated rates of self-harm.</p>
spellingShingle Erlangsen, A
Qin, P
Madsen, T
Hawton, K
Hjorthøj, C
Molbak, K
Laursen, TM
Nordentoft, M
Nilsson, SF
Association between SARS-CoV-2 infection and self-harm: Danish nationwide register-based cohort study
title Association between SARS-CoV-2 infection and self-harm: Danish nationwide register-based cohort study
title_full Association between SARS-CoV-2 infection and self-harm: Danish nationwide register-based cohort study
title_fullStr Association between SARS-CoV-2 infection and self-harm: Danish nationwide register-based cohort study
title_full_unstemmed Association between SARS-CoV-2 infection and self-harm: Danish nationwide register-based cohort study
title_short Association between SARS-CoV-2 infection and self-harm: Danish nationwide register-based cohort study
title_sort association between sars cov 2 infection and self harm danish nationwide register based cohort study
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