The British journal of psychiatry : the journal of mental science · 2026
Factors associated with self-harm in patients with substance use disorders who died by suicide: national hybrid questionnaire registry study.
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Myhre Martin Ø, Walby Fredrik A, Klungsøyr Ole, Bramness Jørgen G, Mehlum Lars
Аннотация
BACKGROUND: Self-harm, self-poisoning or self-injury, irrespective of the motivation, is a central risk factor for suicide. Still, there is limited knowledge of self-harm among patients with substance use disorders (SUDs) who die by suicide.
AIMS: We aimed to describe the prevalence of a history of self-harm and identify the factors associated with self-harm, comparing individuals who died by suicide with and without SUDs.
METHOD: We used data from the Norwegian Surveillance System for Suicide in Mental Health and Substance Use Services, which is based on a national linkage between the Norwegian Cause of Death Registry and the Norwegian Patient Registry, to identify individuals who died by suicide within 1 year after last contact with mental health or substance use services (n = 1140). A questionnaire was retrieved for 1041 (91.3%) of these individuals. We used least absolute shrinkage and selection operator (LASSO) regression to select variables and compared patients with and without SUDs. Conditional selective inference was used to improve 90% confidence intervals and p-values.
RESULTS: The prevalence of self-harm was 55% in patients with SUDs and 52.6% in patients without SUDs. Suicidal ideation (odds ratio 2.98 (95% CI 1.74-5.10)) emerged as a factor shared with patients without SUDs, while personality disorders (odds ratio 1.96 (1.12-3.40)) and a history of violence (odds ratio 1.86 (1.20-2.87)) were unique factors for patients with SUDs.
CONCLUSIONS: A history of self-harm is prevalent in patients with SUDs who die by suicide and is associated with suicidal ideation, a history of violence and personality disorders in patients with SUDs.
AIMS: We aimed to describe the prevalence of a history of self-harm and identify the factors associated with self-harm, comparing individuals who died by suicide with and without SUDs.
METHOD: We used data from the Norwegian Surveillance System for Suicide in Mental Health and Substance Use Services, which is based on a national linkage between the Norwegian Cause of Death Registry and the Norwegian Patient Registry, to identify individuals who died by suicide within 1 year after last contact with mental health or substance use services (n = 1140). A questionnaire was retrieved for 1041 (91.3%) of these individuals. We used least absolute shrinkage and selection operator (LASSO) regression to select variables and compared patients with and without SUDs. Conditional selective inference was used to improve 90% confidence intervals and p-values.
RESULTS: The prevalence of self-harm was 55% in patients with SUDs and 52.6% in patients without SUDs. Suicidal ideation (odds ratio 2.98 (95% CI 1.74-5.10)) emerged as a factor shared with patients without SUDs, while personality disorders (odds ratio 1.96 (1.12-3.40)) and a history of violence (odds ratio 1.86 (1.20-2.87)) were unique factors for patients with SUDs.
CONCLUSIONS: A history of self-harm is prevalent in patients with SUDs who die by suicide and is associated with suicidal ideation, a history of violence and personality disorders in patients with SUDs.