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expert reaction to self-harm and risk of premature death

People who have a history of self-harm are more than three times as likely to die prematurely as the general population, with the risk also much higher for individuals living in socially deprived areas, according to a UK study published in The Lancet.

 

Dr Paul Moran, Clinical Senior Lecturer & Honorary Consultant Psychiatrist, Institute of Psychiatry, King’s College London, said:

“We already know that people who self-harm are at greater risk of dying younger.  However, until now, we lacked a fine-grained analysis of the causes of death among people who self-harm.  This paper by Bergen et al provides such an analysis and therefore makes an important contribution to the epidemiological literature on self-harm. 

“In this study, compared to the general population, all-cause mortality was three times higher among those who self-harmed.  On average, men and women dying of natural causes lost over 25 years of life and those dying of external causes lost 40 years of life.  These figures alone highlight the devastating impact of self-harm on individuals and their families.  Diseases of the circulatory and digestive systems were the largest contributors to total years of life lost due to natural causes. 

“Such findings highlight how crucial it is to properly assess the physical health of people who self-harm.  The paper shows that they are clearly a vulnerable population of individuals with multiple health needs and their assessment should include a systemic enquiry (causes of death in this study covered the full range), a physical examination and appropriate investigations when indicated.

“It should be noted that the use of a clinical cohort in this study does limit the generalisability of findings.  By definition, hospital samples are weighted towards sicker individuals and so we cannot assume that the mortality findings will be applicable to the ‘average’ person who self-harms in the community (the majority of whom never seek hospital treatment).  Nevertheless, the study has considerable strengths – notably, its large sample size and the fact that the sample captured three quite diverse populations.”   

 

‘Premature death after self-harm: a multicentre cohort study’ by Bergen et al., published in The Lancet on Tuesday 18th September.

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