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People who self harm have a high mortality from natural causes

BMJ 2012; 345 doi: (Published 27 September 2012) Cite this as: BMJ 2012;345:e6447

Older teenagers and adults who self harm die younger on average than those of a similar age in the general population. Suicide, accidental poisoning, and accidents account for some of the excess mortality, but a cohort study from the UK reports a high risk of death from natural causes too, particularly digestive diseases (standardised mortality ratio 7.5, 95% CI 6.6 to 8.5) and circulatory diseases (2.3, 2.1 to 2.6). Just over 6% of their cohort died during two to 10 years of follow-up, losing more than 30 years of life each. Those who died of natural causes lost 26 years of life on average. Those who died of external causes lost 40 years. Men had a greater excess mortality than women for most causes of death, and for all causes combined (standardised mortality ratio 4.1 v 3.2).

The study tracked close to 31 000 people who presented to an emergency department in one of three UK cities between 2000 and 2007. The excess mortality from natural causes was greatest in the poorest postcode areas, which may be a signal that this vulnerable group has been disproportionately affected by widening health inequalities documented in the UK since the 1990s, say the authors. In general, standardised mortality ratios for people who self harm look worse today than they did decades ago. While others are living longer, this group has been left behind, they write. A sharper focus on their physical needs as well as the more obvious psychosocial problems is overdue.


Cite this as: BMJ 2012;345:e6447

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