Abstract

Background There is limited recent information regarding the risk of self-harm, somatic disorders and premature mortality following discharge from psychiatric hospital in young people.

Objective To measure these risks in young people discharged from a psychiatric hospital as compared with both non-affected controls and non-hospitalised affected controls.

Methods Data were extracted from the French national health records.

Cases were compared with two control groups.

Cases: all individuals aged 12–24 years, hospitalised in psychiatry in France in 2013–2014.

Non-affected controls: matched for age and sex with cases, not hospitalised in psychiatry and no identification of a mental disorder in 2008–2014.

Affected controls: unmatched youths identified with a mental disorder between 2008 and 2014, never hospitalised in psychiatry.

Follow-up of 3 years.

Logistic regression analyses were conducted with these confounding variables: age, sex, past hospitalisation for self-harm, past somatic disorder diagnosis.

Findings The studied population comprised 73 300 hospitalised patients (53.6% males), 219 900 non-affected controls and 9 683 affected controls.

All rates and adjusted risks were increased in hospitalised patients versus both non-affected and affected controls regarding a subsequent hospitalisation for self-harm (HR=105.5, 95% CIs (89.5 to 124.4) and HR=1.5, 95% CI (1.4 to 1.6)), a somatic disorder diagnosis (HR=4.1, 95% CI (3.9–4.1) and HR=1.4, 95% CI (1.3–1.5)), all-cause mortality (HR=13.3, 95% CI (10.6–16.7) and HR=2.2, 95% CI (1.5–3.0)) and suicide (HR=9.2, 95% CI (4.3–19.8) and HR=1.7, 95% CI (1.0–2.9)).

Conclusions The first 3 years following psychiatric hospital admission of young people is a period of high risk for self-harm, somatic disorders and premature mortality.

Clinical implications Attention to these negative outcomes urgently needs to be incorporated in aftercare policies.

Citations

Jollant F, Goueslard K, Hawton K, Catherine Quantin. Self-harm, somatic disorders and mortality in the 3 years following a hospitalisation in psychiatry in adolescents and young adultsEvidence-Based Mental Health Published Online First: 28 March 2022

DOI: http://dx.doi.org/10.1136/ebmental-2021-300409

URI: https://www.oxfordhealth.nhs.uk/orka/title/self-harm-somatic-disorders-and-mortality-in-the-3-years-following-a-hospitalisation-in-psychiatry-in-adolescents-and-young-adults/