Mortality and suicide after self-harm: community cohort study in Taiwan

TLDR: Results in this sample support the recommendation that people with a history of recent self-harm should be a major target for suicide prevention programmes and use of more lethal methods in the index episode was associated with higher mortality.

Abstract: Background Little is known about outcomes after self-harm in East Asia. Aims To investigate mortality after self-harm in a Taiwanese population. Method Between 2000 and 2003, 1083 individuals who self-harmed were identified through a population self-harm register in Nantou County, Taiwan, and followed until 2007 for date and cause of death on a national mortality database. Results In total, 145 individuals died, 48 through suicide. The risks of all-cause and suicide mortality in the first year were 4.7% and 2.1% respectively, representing 8- and 131-fold age- and gender-standardised increases. Male gender and older age were independent risk factors for both suicide and non-suicide mortality. Use of more lethal methods in the index episode was associated with higher mortality but this was accounted for by gender. Conclusions Results in this sample support the recommendation that people with a history of recent self-harm should be a major target for suicide prevention programmes.