TY  - JOUR
PY  - 2023//
TI  - Physical injuries as triggers for self-harm: a within-individual study of nearly 250 000 injured people with a major psychiatric disorder
JO  - BMJ mental health
A1  - Sariaslan, Amir
A1  - Larsson, Henrik
A1  - Hawton, Keith
A1  - Pitkänen, Joonas
A1  - Lichtenstein, Paul
A1  - Martikainen, Pekka
A1  - Fazel, Seena
SP  - e300758
EP  - e300758
VL  - 26
IS  - 1
N2  - 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>
LA  - en
SN  - 2755-9734
UR  - http://dx.doi.org/10.1136/bmjment-2023-300758
ID  - ref1
ER  -