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Asthma and migraine linked to higher risk of admission for self-harm

GPs and other healthcare practitioners need to be vigilant, recommend authors

Caroline White

Monday, 17 February 2014

Certain long-term physical disorders, such as asthma and migraine, may boost the risk of self- harm, indicates a comparative study of hospital admissions after an episode of deliberate injury in England, and published in the Journal of the Royal Society of Medicine.

Over 200,000 people are admitted to hospital every year in England as a result of self-harm, and people who self-harm have a substantially increased risk of suicide.

The new National Suicide Prevention Strategy for England includes several priority groups including people with a history of self-harm, young people, and those living with long-term physical health conditions.

The peak age for self-harm is 15–24 years, and suicide is the third leading cause of death in this age group.

While it’s well known that psychiatric illness greatly increases the risk of self-harm, it’s less clear whether physical disorders have a similar impact.

The researchers therefore looked at risk of hospital admission for self-harm among people with different long-term psychiatric and physical disorders across England, using a linked dataset of Hospital Episode Statistics (HES) for 1999–2011.

The psychiatric illnesses studied included depression, bipolar disorder, alcohol abuse, anxiety disorders, eating disorders, schizophrenia and substance abuse.

Unsurprisingly, the analysis showed that patients with these conditions were at much greater risk. They were more than five times as likely to self-harm as those without these conditions, the findings showed.

But certain physical ailments also seemed to be linked to an increased risk of self-harm. Among the physical illnesses studied, patients with epilepsy were around three times more likely to self-harm, while those with asthma or migraine were almost twice as likely to do so.

Patients with psoriasis and diabetes also had a moderately increased risk of self-harm of around 60%, while those with eczema and inflammatory polyarthropathies were around 40% more likely to do so.

Patients with cancers under the age of 65, congenital heart disease, ulcerative colitis, sickle cell anaemia and Down’s syndrome were less likely to self-harm.

“It is important for physicians, general practitioners and mental health workers to be aware of the physical disorders that are associated with an increased risk of self-harm so that at-risk individuals may be better identified and can be monitored for any psychiatric symptoms and mental distress,” write the authors.

Much greater integration of medical and mental health services is needed, they say.

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