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Self-harm linked to shorter life expectancy

Patients who self-harmed were at an increased risk for premature death, according to study results published in The Lancet.

“Physical health problems are often poorly treated in people with mental disorders, leading to reduced life expectancy,” the researchers wrote. “As well as being at high risk for suicide, most patients who self-harm have psychiatric disorders. It is important to know the extent of physical health problems in this population, and the study of mortality after self-harm is one approach.”

Helen Bergen, PhD, of the University of Oxford’s Centre for Suicide Research in the United Kingdom, and colleagues studied patients of all ages who presented to emergency departments in Oxford, Manchester and Derby, United Kingdom, after self-injuring or self-poisoning between 2000 and 2007. Patients were followed up to the end of 2009. The researchers examined mortality data from the National Health Service and calculated age-standardized mortality ratios (SMR) and years of life lost.

A total of 30,950 patients presented with self-harm during the study period, and 1,832 (6.1%) died before the end of follow-up. Compared with the general population, death was more likely in patients (SMR=3.6; 95% CI, 3.5-3.8), occurring more in males (SMR=4.1; 95% CI, 3.8-4.3) vs. females (SMR=3.2; 95% CI, 2.9-3.4). Deaths as a result of natural causes were two to 7.5 times more frequent than expected, according to the researchers. Among patients who died of any cause, the mean years of life lost was 31.4 years for males (95% CI, 30.5-32.2) and 30.7 years for females (95% CI, 29.5-31.9).

“Our findings have large public health implications, and emphasize the important role of psychosocial assessment and the need for close attention to physical health disorders in the care of people who self-harm,” the researchers wrote. “The relation between physical and mental health is complex, and neither should be assessed or treated in isolation.”

Disclosure: The researchers report no relevant financial disclosures.