Psychosocial therapy and causes of death after deliberate self-harm: A register-based, nationwide multicentre study using propensity score matching

J. Birkbak, E. A. Stuart, B. D. Lind, P. Qin, E. Stenager, K. J. Larsen, A. G. Wang, A. C. Nielsen, C. M. Pedersen, J. H. Winslov, C. Langhoff, C. Mühlmann, M. Nordentoft, A. Erlangsen

Research output: Contribution to journalArticle

Abstract

Background Psychosocial therapy after deliberate self-harm might be associated with reduced risk of specific causes of death. Method In this matched cohort study, we included patients, who after an episode of deliberate self-harm received psychosocial therapy at a Suicide Prevention Clinic in Denmark between 1992 and 2010. We used propensity score matching in a 1:3 ratio to select a comparison group from 59 046 individuals who received standard care. National Danish registers supplied data on specific causes of death over a 20-year follow-up period. Results At the end of follow-up, 391 (6.9%) of 5678 patients in the psychosocial therapy group had died, compared with 1736 (10.2%) of 17 034 patients in the matched comparison group. Lower odds ratios of dying by mental or behavioural disorders [0.54, 95% confidence interval (CI) 0.37-0.79], alcohol-related causes (0.63, 95% CI 0.50-0.80) and other diseases and medical conditions (0.61, 95% CI 0.49-0.77) were noted in the psychosocial therapy group. Also, we found a reduced risk of dying by suicide as well as other external causes, however, not by neoplasms and circulatory system diseases. Numbers needed to treat were 212.9 (95% CI 139.5-448.4) for mental or behavioural disorders as a cause of death, 111.1 (95% CI 79.2-210.5) for alcohol-related causes and 96.8 (95% CI 69.1-161.8) for other diseases and medical conditions. Conclusions Our findings indicate that psychosocial therapy after deliberate self-harm might reduce long-term risk of death from select medical conditions and external causes. These promising results should be tested in a randomized design.

Original languageEnglish (US)
Pages (from-to)3419-3427
Number of pages9
JournalPsychological medicine
Volume46
Issue number16
DOIs
StatePublished - Dec 1 2016

Keywords

  • Deliberate self-harm
  • mortality
  • preventive medicine
  • psychosocial therapy
  • suicide

ASJC Scopus subject areas

  • Applied Psychology
  • Psychiatry and Mental health

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    Birkbak, J., Stuart, E. A., Lind, B. D., Qin, P., Stenager, E., Larsen, K. J., Wang, A. G., Nielsen, A. C., Pedersen, C. M., Winslov, J. H., Langhoff, C., Mühlmann, C., Nordentoft, M., & Erlangsen, A. (2016). Psychosocial therapy and causes of death after deliberate self-harm: A register-based, nationwide multicentre study using propensity score matching. Psychological medicine, 46(16), 3419-3427. https://doi.org/10.1017/S0033291716001872