Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress 2023 EHA Congress 2023 ASCO Annual Meeting
Clinical Collections
Advances in Alzheimer’s

At a glance: The ONWARDS insulin icodec trials

A round-up of the ONWARDS phase 3 clinical trials evaluating the novel weekly insulin icodec in people with diabetes.
ADVANCED SEARCH
Log in
Top
Child and Adolescent Psychiatry and Mental Health
Published in: Child and Adolescent Psychiatry and Mental Health 1/2017

Open Access 01-12-2017 | Research Article

Adolescent health and subsequent risk of self-harm hospitalisation: a 15-year follow-up of the Young-HUNT cohort

Authors: Asbjørn Junker, Johan Håkon Bjørngaard, Ottar Bjerkeset

Published in: Child and Adolescent Psychiatry and Mental Health | Issue 1/2017

Login to get access

Abstract

Background

Self-harm is associated with increased suicide risk, and constitutes a major challenge in adolescent mental healthcare. In the current study, we examined the association between different aspects of adolescent health and risk of later self-harm requiring hospital admission.

Methods

We linked baseline information from 13 to 19 year old participants (n = 8965) in the Norwegian Young-HUNT 1 study to patient records of self-harm hospitalisation during 15 years of follow-up. We used Cox regression to estimate risk factor hazard ratios (HR).

Results

Eighty-nine persons (71% female) were admitted to hospital because of self-harm. Intoxication/self-poisoning was the most frequent method (81%). Both mental (anxiety/depression, loneliness, being bullied) and somatic (epilepsy, migraine) health issues were associated with up to fourfold increased risk of self-harm-related hospital admission.

Conclusions

Several health issues during adolescence markedly increased the risk of later self-harm hospitalisation. Current findings should be incorporated in the strive to reduce self-harming and attempted suicides among young people.
Literature
1.
Sinclair JM, Gray A, Rivero-Arias O, Saunders KE, Hawton K. Healthcare and social services resource use and costs of self-harm patients. Soc Psychiatry Psychiatr Epidemiol. 2011;46:263–71.CrossRefPubMed
2.
3.
Hawton K, Harriss L, Hall S, Simkin S, Bale E, Bond A. Deliberate self-harm in Oxford, 1990–2000: a time of change in patient characteristics. Psychol Med. 2003;33:987–95.CrossRefPubMed
4.
5.
Hawton K, Saunders KE, O’Connor RC. Self-harm and suicide in adolescents. Lancet. 2012;379:2373–82.CrossRefPubMed
6.
Madge N, Hewitt A, Hawton K, de Wilde EJ, Corcoran P, Fekete S, et al. Deliberate self-harm within an international community sample of young people: comparative findings from the Child and Adolescent Self-harm in Europe (CASE) Study. J Child Psychol Psychiatry. 2008;49:667–77.CrossRefPubMed
7.
Kopjar B, Dieserud G, Wiik J. Deliberate self-poisonings treated in hospitals. Tidsskr Nor Laegeforen. 2005;125:1798–800.PubMed
8.
9.
Nock MK, Joiner TE Jr, Gordon KH, Lloyd-Richardson E, Prinstein MJ. Non-suicidal self-injury among adolescents: diagnostic correlates and relation to suicide attempts. Psychiatry Res. 2006;144:65–72.CrossRefPubMed
10.
Junker A, Bjorngaard JH, Gunnell D, Bjerkeset O. Sleep problems and hospitalization for self-harm: a 15-year follow-up of 9000 Norwegian adolescents. The Young-HUNT Study. Sleep. 2014;37:579–85.CrossRefPubMedPubMedCentral
11.
Hysing M, Sivertsen B, Stormark KM, O’Connor RC. Sleep problems and self-harm in adolescence. Br J Psychiatry. 2015;207:306–12.CrossRefPubMed
12.
Stokes ML, McCoy KP, Abram KM, Byck GR, Teplin LA. Suicidal ideation and behavior in youth in the juvenile justice system: a review of the literature. J Correct Health Care. 2015;21:222–42.CrossRefPubMed
13.
Singhal A, Ross J, Seminog O, Hawton K, Goldacre MJ. Risk of self-harm and suicide in people with specific psychiatric and physical disorders: comparisons between disorders using English national record linkage. J R Soc Med. 2014;107:194–204.CrossRefPubMedPubMedCentral
14.
Kolla NJ, Eisenberg H, Links PS. Epidemiology, risk factors, and psychopharmacological management of suicidal behavior in borderline personality disorder. Arch Suicide Res. 2008;12:1–19.CrossRefPubMed
15.
Black DW, Blum N, Pfohl B, Hale N. Suicidal behavior in borderline personality disorder: prevalence, risk factors, prediction, and prevention. J Pers Disord. 2004;18:226–39.CrossRefPubMed
16.
17.
Lopez-Munoz F, Garcia-Garcia P, Saiz-Ruiz J, Mezzich JE, Rubio G, Vieta E, Alamo C. A bibliometric study of the use of the classification and diagnostic systems in psychiatry over the last 25 years. Psychopathology. 2008;41:214–25.CrossRefPubMed
18.
Mars B, Cornish R, Heron J, Boyd A, Crane C, Hawton K, et al. Using data linkage to investigate inconsistent reporting of self-harm and questionnaire non-response. Arch Suicide Res. 2016;20:113–41.CrossRefPubMedPubMedCentral
19.
Groholt B, Ekeberg O, Haldorsen T. Adolescents hospitalised with deliberate self-harm: the significance of an intention to die. Eur Child Adolesc Psychiatry. 2000;9:244–54.CrossRefPubMed
20.
Haw C, Casey D, Holmes J, Hawton K. Suicidal intent and method of self-harm: a large-scale study of self-harm patients presenting to a general hospital. Suicide Life Threat Behav. 2015;45:732–46.CrossRefPubMed
21.
Holmen TL, Bratberg G, Krokstad S, Langhammer A, Hveem K, Midthjell K, et al. Cohort profile of the Young-HUNT Study, Norway: a population-based study of adolescents. Int J Epidemiol. 2014;43:536–44.CrossRefPubMed
22.
Strand BH, Dalgard OS, Tambs K, Rognerud M. Measuring the mental health status of the Norwegian population: a comparison of the instruments SCL-25, SCL-10, SCL-5 and MHI-5 (SF-36). Nord J Psychiatry. 2003;57:113–8.CrossRefPubMed
23.
Tambs K. Undersøkelse av seksuelle overgrep mot barn. Oslo: Statens institutt for folkehelse; 1994.
24.
Cole TJ, Flegal KM, Nicholls D, Jackson AA. Body mass index cut offs to define thinness in children and adolescents: international survey. BMJ. 2007;335:194.CrossRefPubMedPubMedCentral
25.
Cole TJ, Bellizzi MC, Flegal KM, Dietz WH. Establishing a standard definition for child overweight and obesity worldwide: international survey. BMJ. 2000;320:1240–3.CrossRefPubMedPubMedCentral
26.
Asher MI, Keil U, Anderson HR, Beasley R, Crane J, Martinez F, et al. International Study of Asthma and Allergies in Childhood (ISAAC): rationale and methods. Eur Respir J. 1995;8:483–91.CrossRefPubMed
27.
Strandheim A, Holmen TL, Coombes L, Bentzen N. Alcohol intoxication and mental health among adolescents—a population review of 8983 young people, 13–19 years in North-Trondelag, Norway: the Young-HUNT Study. Child Adolesc Psychiatry Ment Health. 2009;3:18.CrossRefPubMedPubMedCentral
28.
29.
30.
Grambsch PM, Therneau TM. Proportional hazards tests and diagnostics based on weighted residuals. Biometrika. 1994;81:515–26.CrossRef
31.
32.
Carroll R, Metcalfe C, Gunnell D. Hospital presenting self-harm and risk of fatal and non-fatal repetition: systematic review and meta-analysis. PLoS ONE. 2014;9:e89944.CrossRefPubMedPubMedCentral
33.
Haw C, Hawton K, Houston K, Townsend E. Psychiatric and personality disorders in deliberate self-harm patients. Br J Psychiatry. 2001;178:48–54.CrossRefPubMed
34.
Beautrais AL, Joyce PR, Mulder RT. Psychiatric illness in a New Zealand sample of young people making serious suicide attempts. N Z Med J. 1998;111:44–8.PubMed
35.
Tyrer P. The case for cothymia: mixed anxiety and depression as a single diagnosis. Br J Psychiatry. 2001;179:191–3.CrossRefPubMed
36.
Sareen J, Cox BJ, Afifi TO, de Graaf R, Asmundson GJ, ten Have M, et al. Anxiety disorders and risk for suicidal ideation and suicide attempts: a population-based longitudinal study of adults. Arch Gen Psychiatry. 2005;62:1249–57.CrossRefPubMed
37.
Mykletun A, Bjerkeset O, Dewey M, Prince M, Overland S, Stewart R. Anxiety, depression, and cause-specific mortality: the HUNT study. Psychosom Med. 2007;69:323–31.CrossRefPubMed
38.
Kessler RC, Berglund P, Demler O, Jin R, Merikangas KR, Walters EE. Lifetime prevalence and age-of-onset distributions of DSM-IV disorders in the National Comorbidity Survey Replication. Arch Gen Psychiatry. 2005;62:593–602.CrossRefPubMed
39.
Hannon G, Taylor EP. Suicidal behaviour in adolescents and young adults with ASD: findings from a systematic review. Clin Psychol Rev. 2013;33:1197–204.CrossRefPubMed
40.
Rossow I, Groholt B, Wichstrom L. Intoxicants and suicidal behaviour among adolescents: changes in levels and associations from 1992 to 2002. Addiction. 2005;100:79–88.CrossRefPubMed
41.
Bjarnason T, Thorlindsson T. Manifest predictors of past suicide attempts in a population of Icelandic adolescents. Suicide Life Threat Behav. 1994;24:350–8.PubMed
42.
Nrugham L, Larsson B, Sund AM. Predictors of suicidal acts across adolescence: influences of familial, peer and individual factors. J Affect Disord. 2008;109:35–45.CrossRefPubMed
43.
Lereya ST, Winsper C, Heron J, Lewis G, Gunnell D, Fisher HL, et al. Being bullied during childhood and the prospective pathways to self-harm in late adolescence. J Am Acad Child Adolesc Psychiatry. 2013;52(608–18):e2.
44.
Barnes AJ, Eisenberg ME, Resnick MD. Suicide and self-injury among children and youth with chronic health conditions. Pediatrics. 2010;125:889–95.CrossRefPubMed
45.
Scott KM, Hwang I, Chiu WT, Kessler RC, Sampson NA, Angermeyer M, et al. Chronic physical conditions and their association with first onset of suicidal behavior in the world mental health surveys. Psychosom Med. 2010;72:712–9.CrossRefPubMed
46.
Meyer N, Voysey M, Holmes J, Casey D, Hawton K. Self-harm in people with epilepsy: a retrospective cohort study. Epilepsia. 2014;55:1355–65.CrossRefPubMed
47.
Colman I, Kingsbury M, Sareen J, Bolton J, van Walraven C. Migraine headache and risk of self-harm and suicide: a population-based study in Ontario, Canada. Headache. 2016;56:132–40.CrossRefPubMed
48.
Nguyen TV, Low NC. Comorbidity of migraine and mood episodes in a nationally representative population-based sample. Headache. 2013;53:498–506.CrossRefPubMed
49.
Gelfand AA. Psychiatric comorbidity and paediatric migraine: examining the evidence. Curr Opin Neurol. 2015;28:261–4.CrossRefPubMed
50.
Baldin E, Hesdorffer DC, Caplan R, Berg AT. Psychiatric disorders and suicidal behavior in neurotypical young adults with childhood-onset epilepsy. Epilepsia. 2015;56:1623–8.CrossRefPubMedPubMedCentral
51.
Spiegel B, Schoenfeld P, Naliboff B. Systematic review: the prevalence of suicidal behaviour in patients with chronic abdominal pain and irritable bowel syndrome. Aliment Pharmacol Ther. 2007;26:183–93.CrossRefPubMed
52.
Goodwin RD, Eaton WW. Asthma, suicidal ideation, and suicide attempts: findings from the Baltimore epidemiologic catchment area follow-up. Am J Public Health. 2005;95:717–22.CrossRefPubMedPubMedCentral
53.
Aseltine RH Jr, Schilling EA, James A, Glanovsky JL, Jacobs D. Age variability in the association between heavy episodic drinking and adolescent suicide attempts: findings from a large-scale, school-based screening program. J Am Acad Child Adolesc Psychiatry. 2009;48:262–70.CrossRefPubMed
54.
Moller CI, Tait RJ, Byrne DG. Self-harm, substance use and psychological distress in the Australian general population. Addiction. 2013;108:211–20.CrossRefPubMed
55.
Bjorngaard JH, Gunnell D, Elvestad MB, Davey Smith G, Skorpen F, Krokan H, et al. The causal role of smoking in anxiety and depression: a Mendelian randomization analysis of the HUNT study. Psychol Med. 2013;43:711–9.CrossRefPubMed
Metadata
Title
Adolescent health and subsequent risk of self-harm hospitalisation: a 15-year follow-up of the Young-HUNT cohort
Authors
Asbjørn Junker
Johan Håkon Bjørngaard
Ottar Bjerkeset
Publication date
01-12-2017
Publisher
BioMed Central
Published in
Child and Adolescent Psychiatry and Mental Health / Issue 1/2017
Electronic ISSN: 1753-2000
DOI
https://doi.org/10.1186/s13034-017-0161-8

Other articles of this Issue 1/2017

Child and Adolescent Psychiatry and Mental Health 1/2017 Go to the issue

Research article

Diagnostic profiles and predictors of treatment outcome among children and adolescents attending a national psychiatric hospital in Botswana

Research article

Effect of attention-deficit–hyperactivity-disorder training program on the knowledge and attitudes of primary school teachers in Kaduna, North West Nigeria

Review

Tourette syndrome and other neurodevelopmental disorders: a comprehensive review

Research Article

The contribution of parent and youth information to identify mental health disorders or problems in adolescents

Research article

Identifying cross-cultural variations in psychostimulant use for attention deficit hyperactivity disorder using linked data

Research article

Body image drawings dissociate ethnic differences and anorexia in adolescent girls