Higher suicide risk for early self-harmers
Young adult self-harmers run a higher risk of also committing suicide, a new study from Karolinska Institutet published in the journal Psychological Medicine reports. The risk of suicide is 16 times higher in people who have been treated for self-harming behaviour than in their peers.
The current study concerns self-harming in young people and how it impacts on the risk of mental illness or suicide later in life. While self-harm is relatively common, particularly amongst the young, not very much is known about what becomes of these individuals later in life.
The aim of the study was to see if self-harming at a young age is an expression of a temporary crisis or of a more chronic mental problem.
“We also wanted to find out if the risk of suicide increases and who is at the greatest risk of mental illness and suicide,” says lead author Karin Beckman, specialist in psychiatry and doctoral student at the Department of Clinical Neuroscience.
The study involved 13,731 individuals between the ages of 18 and 24 who had been treated for self-harm between 1990 and 2003, along with 137,310 who had not[NB1] . The average follow-up time was 12.2 years after treatment and 62.3 per cent of the participants were female. All individuals who were hospitalised for self-harm for the first time in Sweden during this period were included in the study, which used anonymised information from six Swedish registries, including the Swedish National Patient Register and the Swedish Prescribed Drug Register.
The study showed that the risk of suicide is 16 times higher in young adults who had been hospitalised in connection with self-harm than in their peers. The researchers also observed that many of them had persistent psychiatric problems: a follow-up five years after the self-harm episode revealed that one in five were receiving in-patient psychiatric care and half were being treated with psychiatric drugs.
Having a mental illness, particularly a psychosis, before or in connection with self-harm increased the risk of problems later in life as regards both suicide and psychiatric ill-health.
“Our results show that we have to focus more on young adults who self-harm if we’re to reduce the risk of their developing psychiatric issues as adults and of suicide,” says Dr Beckman. “Doctors dealing with self-harm should also carefully assess and deal with any mental illnesses, since they have significant consequences for later negative prognoses.”
She continues: “We still know regrettably little about what happens to individuals who self-harm but who remain under healthcare service radar. We also have to learn more about what makes many early self-harmers cope well in the future and about what intervention best helps them.”
The study was financed with grants from the Swedish Council for Working Life and Social Research (FAS), the Bror Gadelius Memorial Fund and the Swedish Research Council.
“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”
Karin Beckman, Ellenor Mittendorfer-Rutz, Paul Lichtenstein, Henrik Larsson, Catarina Almqvist, Bo Runeson, Marie Dahlin.
Psychological Medicine, published online 20 September, 2016, doi:http://dx.doi.org/10.1017/S0033291716002282