Premature Death Among Primary Care Patients With a History of Self-Harm

The Article in Brief

Premature Death Among Primary Care Patients With a History of Self-Harm

Matthew J. Carr , and colleagues

Background Self-harm is a major public health problem. This study investigates risk of dying prematurely from any cause after self-harm.

What This Study Found Primary care patients who have harmed themselves are at greatly increased risk of dying prematurely by natural and unnatural causes, especially within a year of a self-harm episode. Among 30,017 patients aged 15 to 64 years, there was an elevated risk of dying prematurely from any cause among the self-harm group, especially in the first year of follow-up. In particular, suicide risk was especially high in the first year. Although it declined sharply after one year, it remained much higher than in the comparison group. During the 10-year follow-up period there were also large increases in risk for accidental, alcohol-related and drug-poisoning deaths.

Implications

• The authors point out that patients with a history of self-harm visit clinicians at a relatively high frequency, which presents a clear opportunity for preventive action. They call for national guidelines that provide more specific recommendations and training on how primary care teams can more effectively intervene, manage, and monitor risk in these patients.