@article{ref1,
title="Physical injuries as triggers for self-harm: a within-individual study of nearly 250 000 injured people with a major psychiatric disorder",
journal="BMJ mental health",
year="2023",
author="Sariaslan, Amir and Larsson, Henrik and Hawton, Keith and Pitkänen, Joonas and Lichtenstein, Paul and Martikainen, Pekka and Fazel, Seena",
volume="26",
number="1",
pages="e300758-e300758",
abstract="BACKGROUND: Although there is robust evidence for several factors which may precipitate self-harm, the contributions of different physical injuries are largely unknown. <br><br>OBJECTIVE: To examine whether specific physical injuries are associated with risks of self-harm in people with psychiatric disorders. <br><br>METHODS: By using population and secondary care registers, we identified all people born in Finland (1955-2000) and Sweden (1948-1993) with schizophrenia-spectrum disorder (n=136 182), bipolar disorder (n=68 437) or depression (n=461 071). Falls, transport-related injury, traumatic brain injury and injury from interpersonal assault were identified within these subsamples. We used conditional logistic regression models adjusted for age and calendar month to compare self-harm risk in the week after each injury to earlier weekly control periods, which allowed us to account for unmeasured confounders, including genetics and early environments. <br><br>FINDINGS: A total of 249 210 individuals had been diagnosed with a psychiatric disorder and a physical injury during the follow-up. The absolute risk of self-harm after a physical injury ranged between transport-related injury and injury from interpersonal assault (averaging 17.4-37.0 events per 10 000 person-weeks). Risk of self-harm increased by a factor of two to three (adjusted OR: 2.0-2.9) in the week following a physical injury, as compared with earlier, unexposed periods for the same individuals. <br><br>CONCLUSIONS: Physical injuries are important proximal risk factors for self-harm in people with psychiatric disorders. CLINICAL IMPLICATIONS: Mechanisms underlying the associations could provide treatment targets. When treating patients with psychiatric illnesses, emergency and trauma medical services should actively work in liaison with psychiatric services to implement self-harm prevention strategies.<p /> <p>Language: en</p>",
language="en",
issn="2755-9734",
doi="10.1136/bmjment-2023-300758",
url="http://dx.doi.org/10.1136/bmjment-2023-300758"
}