ArticleAnnals of family medicine2017
Premature Death Among Primary Care Patients With a History of Self-Harm.
Article in Annals of family medicine, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 22 papers, 1 of them a synthesis that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
22 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Osteoporosis and fracture as risk factors for self-harm and suicide: a systematic review and meta-analysis.The British journal of general practice : the journal of the Royal College of General Practitioners · 2023Pooled it
- Antidepressant treatment and risk of subsequent bipolar disorder in adolescents with unipolar depression.BMJ mental health · 2025Article
- Incidence and prognostic factors of self-harm and subsequent unnatural death in South Africa: A cohort study.PLoS medicine · 2025Article
- Repeat self-harm hospitalizations in Canada: a survival analysis.Injury epidemiology · 2025Article
- Use of Data Linkage Methods to Investigate Healthcare Interactions in Individuals Who Self-harm and Die by Suicide: A Scoping Review.Journal of preventive medicine and public health = Yebang Uihakhoe chi · 2025Article
- Risk factors, impact, and healthcare use related to initial suicide attempts: comprehensive analysis of Swedish population.BMJ medicine · 2025Article
- How GPs can help young people avoid future self-harm: a qualitative study.The British journal of general practice : the journal of the Royal College of General Practitioners · 2024Article
- Developing a clinical decision support system software prototype that assists in the management of patients with self-harm in the emergency department: protocol of the PERMANENS project.BMC psychiatry · 2024Article
- Self-reported suicidal behaviours and associated factors in the general population of Latvia (2010-2018).The International journal of social psychiatry · 2023Article
- Thematic analysis of the psycho-sexual symptoms in patients with Peyronie's disease present on online forums.International journal of impotence research · 2023Article
- Improving the management of self-harm in primary care.The British journal of general practice : the journal of the Royal College of General Practitioners · 2023Article
- 'Wasn't offered one, too poorly to ask for one' - Reasons why some patients do not receive a psychosocial assessment following self-harm: Qualitative patient and carer survey.The Australian and New Zealand journal of psychiatry · 2022Article
- Working with Young People at Risk of Suicidal Behaviour and Self-Harm: A Qualitative Study of Australian General Practitioners' Perspectives.International journal of environmental research and public health · 2021Article
- Article
- Article
- Article
- Incidence and general hospital costs of self-harm across England: estimates based on the multicentre study of self-harm.Epidemiology and psychiatric sciences · 2020Article
- The Secure Anonymised Information Linkage databank Dementia e-cohort (SAIL-DeC).International journal of population data science · 2020Article
- Coding algorithms for defining Charlson and Elixhauser co-morbidities in Read-coded databases.BMC medical research methodology · 2019Article
- Adolescent self-harm with and without suicidality: cross-sectional and longitudinal analyses of a Swedish regional register.Journal of child psychology and psychiatry, and allied disciplines · 2019Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
9 authors.
Funding
Abstract
purposeSelf-harm is a public health problem that requires a better understanding of mortality risk. We undertook a study to examine premature mortality in a nationally representative cohort of primary care patients who had harmed themselves.
methodsDuring 2001-2013, a total of 385 general practices in England contributed data to the Clinical Practice Research Datalink with linkage to Office for National Statistics mortality records. We identified 30,017 persons aged 15 to 64 years with a recorded episode of self-harm. We estimated the relative risks of all-cause and cause-specific natural and unnatural mortality using a comparison cohort of 600,258 individuals matched on age, sex, and general practice.
resultsWe found an elevated risk of dying prematurely from any cause among the self-harm cohort, especially in the first year of follow-up (adjusted hazard ratio for that year, 3.6; 95% CI, 3.1-4.2). In particular, suicide risk was especially high during the first year (adjusted hazard ratio, 54.4; 95% CI, 34.3-86.3); although it declined sharply, it remained much higher than that in the comparison cohort. Large elevations of risk throughout the follow-up period were also observed for accidental, alcohol-related, and drug poisoning deaths. At 10 years of follow-up, cumulative incidence values were 6.5% (95% CI, 6.0%-7.1%) for all-cause mortality and 1.3% (95% CI, 1.2%-1.5%) for suicide.
conclusionsPrimary care patients who have harmed themselves are at greatly increased risk of dying prematurely by natural and unnatural causes, and especially within a year of a first episode. These individuals visit clinicians at a relatively high frequency, which presents a clear opportunity for preventive action. Primary care patients with myriad comorbidities, including self-harming behavior, mental disorder, addictions, and physical illnesses, will require concerted, multipronged, multidisciplinary collaborative care approaches.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.