@article{ref1,
title="Sex differences in self-harm and suicide in young autistic adults",
journal="Acta psychiatrica Scandinavica",
year="2024",
author="Hull, Laura and Stark, Isidora and Lundberg, Michael and Ahlqvist, Viktor H. and Nordström, Selma Idring and Ohlis, Anna and Hadlaczky, Gergo and Rai, Dheeraj and Magnusson, Cecilia",
volume="ePub",
number="ePub",
pages="ePub-ePub",
abstract="INTRODUCTION: Both suicide and self-harm are disproportionately common in autistic people. Sex differences in risk of self-harm and suicide are observed in the general population, but findings are mixed for autistic people. Self-cutting may be a particularly risky self-harm behaviour for suicide in autistic people. We aimed to explore sex differences and differences in method of self-harm in the association between self-harm and suicide in autistic and non-autistic adolescents and young adults. <br><br>METHODS: We used a total population register of 2.8 million Swedish residents. Participants were followed from age 12 until December 2021 for medical treatment because of self-harm, and death from suicide. We used Cox proportional hazard regression models to calculate hazard ratios (HRs) and 95% confidence intervals (CIs) for risk of death from suicide following self-harm, and Relative Excessive Risk due to Interaction (RERI) to explore the interaction between self-harm and autism in females and males. <br><br>RESULTS: We identified 85,143 autistic individuals (31,288 female; 53,855 male) and 2,628,382 non-autistic individuals (1,286,481 female; 1,341,901 male) aged 12-37 years. Incidence of suicide following self-harm was higher in autistic males (incidence per 100,000 risk-years = 169.0 [95% CI 135.1, 211.3]) than females (125.4 [99.4, 158.3]). The relative risk was higher for autistic females (HR 26.1 [95% CI 20.2, 33.7]) than autistic males (12.5 [9.9, 15.8]). An additive effect of both autism and self-harm was observed in both females (RERI = 9.8) and males (2.0). Autistic individuals who self-harmed through cutting were at greatest risk of death from suicide (HR 25.1 [17.9, 35.2]), compared to other methods. <br><br>CONCLUSION: Autistic males and females are at increased risk of death from suicide following severe self-harm, particularly self-cutting.<p /> <p>Language: en</p>",
language="en",
issn="0001-690X",
doi="10.1111/acps.13736",
url="http://dx.doi.org/10.1111/acps.13736"
}