When a person performs an act of self harm, the medical professional's first priority is to get him or her safely past that immediate event. But research published Monday evening in the British medical journal The Lancet finds that people who harm themselves — by intentionally injuring or poisoning themselves, with or without suicidal intent, according to the study’s definition — remain at greater risk of early death from both natural and external causes for years after their initial self-harming incident.
Researchers at the University of Oxford Centre for Suicide Research followed more than 30,950 people who had been treated for self-induced injuries and poisonings at emergency rooms in Britain between 2000 and 2007. The patients were followed through 2009, for a median follow-up of six years. About 6 percent, or 1,832 people, had died by 2009.
The research team gathered general information about the patients’ socioeconomic status (judging from their postal codes), their alcohol and illicit drug use, and their physical and mental health.
Overall, people with a history of self-harm were more than three times as likely to die prematurely from any cause compared with the general population. The most common cause of death was accidental poisoning; suicide was next. Nothing too surprising there. But the people who had a history of self-harm were twice as likely to die from natural causes — such as cardiovascular or gastrointestinal disease or mental and behavioral disorders — compared with the general population. Those risks were much greater among those living in socioeconomically “deprived” areas and rose as that deprivation increased.
The study found strong correlations between alcohol abuse and death from gastrointestinal disease, and between drug abuse and mental and behavioral disorders; there was a similar link between a person’s history of physical health problems at the time of self-harm and death from cardiovascular disease.
The study also used life expectancy tables to calculate the number of years of life lost through premature death among those who had committed acts of self-harm. That amounted to an estimated average loss of 30 years per person. The number of years of life lost averaged about 25 for those who died of natural causes and leaped to an average of about 40 years for those who died of external causes such as self-poisoning and suicide.
The authors of the study and of an accompanying editorial suggest that health-care providers treating people who have performed acts of self-harm should attend not just to those patients’ mental health but their physical health, too. “The relation between physical and mental health is complex, and neither should be assessed or treated in isolation,” the study concludes.