Psychosocial therapy and causes of death after deliberate self-harm: a register-based, nationwide multicentre study using propensity score matching
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Psychosocial therapy and causes of death after deliberate self-harm : a register-based, nationwide multicentre study using propensity score matching. / Birkbak, J; Stuart, A E; 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.
I: Psychological Medicine, Bind 46, Nr. 16, 12.2016, s. 3419-3427.Publikation: Bidrag til tidsskrift › Tidsskriftartikel › Forskning › fagfællebedømt
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TY - JOUR
T1 - Psychosocial therapy and causes of death after deliberate self-harm
T2 - a register-based, nationwide multicentre study using propensity score matching
AU - Birkbak, J
AU - Stuart, A E
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
PY - 2016/12
Y1 - 2016/12
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.
AB - 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.
KW - Journal Article
U2 - 10.1017/S0033291716001872
DO - 10.1017/S0033291716001872
M3 - Journal article
C2 - 27654845
VL - 46
SP - 3419
EP - 3427
JO - Psychological Medicine
JF - Psychological Medicine
SN - 0033-2917
IS - 16
ER -
ID: 177495519