TY  - JOUR
PY  - 2020//
TI  - The risk of deliberate self-harm following a diagnosis of rheumatoid arthritis or ankylosing spondylitis: a population-based cohort study
JO  - PLoS one
A1  - Kuriya, Bindee
A1  - Vigod, Simone
A1  - Luo, Jin
A1  - Widdifield, Jessica
A1  - Haroon, Nigil
SP  - e0229273
EP  - e0229273
VL  - 15
IS  - 2
N2  - OBJECTIVE: Rheumatoid arthritis (RA) and ankylosing spondylitis (AS) are associated with mental illness. The risk of serious mental illness, including deliberate self-harm (DSH), in these conditions is not well known. We aimed to determine if RA or AS independently increases the risk for DSH. <br><br>METHODS: We conducted retrospective, population-based cohort studies using administrative health data for the province of Ontario, Canada between April 1, 2002 and March 31, 2014. Individuals with incident RA (N = 53,240) or AS (N = 13,964) were separately matched 1:4 by age, sex, and year with comparators without RA or AS. The outcome was a first DSH attempt identified using emergency department data. We estimated hazard ratios (HR) and 95% confidence intervals (95% CI) for risk of DSH in RA and AS versus comparators, adjusting for demographic, clinical and health service utilization variables. <br><br>RESULTS: Subjects with AS were significantly more likely to self-harm (crude incidence rate [IR] of 0.68/1,000 person years [PY] versus 0.32/1,000 PY in comparators), with an adjusted HR of 1.59 (95% CI 1.15 to 2.21). DSH was increased for RA subjects (IR 0.35/1,000 PY) versus comparators (IR 0.24/1,000 PY) only before (HR 1.43, 95% CI 1.16 to 1.74), but not after covariate adjustment (HR 1.07, 95% CI 0.86 to 1.33). <br><br>CONCLUSIONS: AS carries an increased risk for DSH but no such risk was observed in RA. Further evaluation of at-risk AS subjects is needed, including the longitudinal effects of disease and arthritis therapies on self-harm behaviour. This will inform whether specific risk-reduction strategies for DSH in inflammatory arthritis are needed.<p />  <p>Language: en</p>
LA  - en
SN  - 1932-6203
UR  - http://dx.doi.org/10.1371/journal.pone.0229273
ID  - ref1
ER  -