ArticleSchizophrenia bulletin2024
Risk of Psychosis Among Individuals Who Have Presented to Hospital With Self-harm: A Prospective Nationwide Register Study in Sweden.
Article in Schizophrenia bulletin, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers, 1 of them a synthesis that pooled it.
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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.
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Who cites it
4 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Sensitivity of the clinical high-risk and familial high-risk approaches for psychotic disorders - a systematic review and meta-analysis.Psychological medicine · 2025Pooled it
- Using Electronic Health Records to Identify Medical Presentation for Self-harm as a Predictor of Psychotic or Bipolar Disorders: A Systems-level Alternative to the Clinical High-risk Approach.Schizophrenia bulletin · 2026Article
- Relationship among Sleep Disturbance, Stress, and Suicidal Ideation in Clinical High Risk for Psychosis.Schizophrenia bulletin open · 2026Article
- From Adolescence to Adulthood: Understanding Care Trajectories in an Early Detection and Intervention Centre in France.Early intervention in psychiatry · 2025Article
Corrections and comments
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Authors and funding
11 authors.
Funding
Abstract
background and hypothesisRecent research showed that young people who presented to hospital with self-harm in Finland had a significantly elevated risk of later psychosis. We investigated the prospective relationship between hospital presentation for self-harm and risk of psychosis in an unprecedentedly large national Swedish cohort. STUDY
designWe used inpatient and outpatient healthcare registers to identify all individuals born between 1981 and 1993 who were alive and living in Sweden on their 12th birthday and who presented to hospital one or more times with self-harm. We compared them with a matched cohort, followed up for up to 20 years, and compared the cumulative incidence of psychotic disorders. Furthermore, we examined whether the strength of the relationship between hospital presentation for self-harm and later psychosis changed over time by examining for cohort effects. STUDY
resultsIn total, 28 908 (2.0%) individuals presented to hospital with self-harm without prior psychosis diagnosis during the follow-up. For individuals who presented to hospital with self-harm, the cumulative incidence of diagnosed psychosis was 20.7% at 20 years follow-up (hazard radio = 13.9, 95% CI 13.3-14.6, P-value <5 × 10-308). There was no evidence of a dilution of the effect over time: while the incidence of hospital self-harm presentation increased, this did not result in an attenuation over time of the strength of the relationship between hospital self-harm presentation and subsequent psychosis.
conclusionsIndividuals who present to hospital with self-harm in their teens and 20s represent an important risk group for psychosis prediction and prevention.
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