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Psychosocial therapy and causes of death after deliberate self-harm: a register-based, nationwide multicentre study using propensity score matching.
Psychol Med. 2016 12; 46(16):3419-3427.PM

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.

Authors+Show Affiliations

Research Unit,Mental Health Centre Copenhagen,University of Copenhagen,Capital Region of Denmark,Denmark.Department of Mental Health,Johns Hopkins Bloomberg School of Public Health,Baltimore, MD,USA.Department of Psychiatry,Clinic of Suicide Prevention and Treatment for Adults,Region of Southern Denmark,Denmark.National Centre for Suicide Research and Prevention, University of Oslo,Oslo,Norway.Psychiatric Research Unit,Aabenraa,University of Southern Denmark,Odense,Denmark.Department of Child and Adolescent Psychiatry,Clinic of Suicide Prevention and Treatment for Children and Adolescents,Region of Southern Denmark,Denmark.Competence Centre for Suicide Prevention,Amager,Capital Region of Denmark,Denmark.Competence Centre for Suicide Prevention,Copenhagen,Capital Region of Denmark,Denmark.Clinic for Suicide Prevention, Aarhus University Hospital Risskov,Aarhus,Central Denmark Region,Denmark.Unit for Suicide Prevention,Aalborg University Hospital,North Denmark Region,Denmark.Clinic for Suicide Prevention,Herning,Central Denmark Region,Denmark.Research Unit,Mental Health Centre Copenhagen,University of Copenhagen,Capital Region of Denmark,Denmark.Research Unit,Mental Health Centre Copenhagen,University of Copenhagen,Capital Region of Denmark,Denmark.Research Unit,Mental Health Centre Copenhagen,University of Copenhagen,Capital Region of Denmark,Denmark.

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

27654845

Citation

Birkbak, J, et al. "Psychosocial Therapy and Causes of Death After Deliberate Self-harm: a Register-based, Nationwide Multicentre Study Using Propensity Score Matching." Psychological Medicine, vol. 46, no. 16, 2016, pp. 3419-3427.
Birkbak J, Stuart EA, Lind BD, et al. Psychosocial therapy and causes of death after deliberate self-harm: a register-based, nationwide multicentre study using propensity score matching. Psychol Med. 2016;46(16):3419-3427.
Birkbak, J., Stuart, E. A., Lind, B. D., Qin, P., Stenager, E., Larsen, K. J., Wang, A. G., Nielsen, A. C., Pedersen, C. M., Winsløv, 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.
Birkbak J, et al. Psychosocial Therapy and Causes of Death After Deliberate Self-harm: a Register-based, Nationwide Multicentre Study Using Propensity Score Matching. Psychol Med. 2016;46(16):3419-3427. PubMed PMID: 27654845.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Psychosocial therapy and causes of death after deliberate self-harm: a register-based, nationwide multicentre study using propensity score matching. AU - Birkbak,J, AU - Stuart,E A, AU - Lind,B D, AU - Qin,P, AU - Stenager,E, AU - Larsen,K J, AU - Wang,A G, AU - Nielsen,A C, AU - Pedersen,C M, AU - Winsløv,J-H, AU - Langhoff,C, AU - Mühlmann,C, AU - Nordentoft,M, AU - Erlangsen,A, Y1 - 2016/09/22/ PY - 2016/9/23/pubmed PY - 2017/11/29/medline PY - 2016/9/23/entrez KW - Deliberate self-harm KW - mortality KW - preventive medicine KW - psychosocial therapy KW - suicide SP - 3419 EP - 3427 JF - Psychological medicine JO - Psychol Med VL - 46 IS - 16 N2 - 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. SN - 1469-8978 UR - https://www.unboundmedicine.com/medline/citation/27654845/Psychosocial_therapy_and_causes_of_death_after_deliberate_self_harm:_a_register_based_nationwide_multicentre_study_using_propensity_score_matching_ DB - PRIME DP - Unbound Medicine ER -