People who have a history of self-harm have a three times higher chance to die prematurely than the general population, and not just from the obvious causes.

Those who self-injure have a 2 times higher risk of dying due to natural causes than expected, according to a study in The Lancet. The investigation, led by Keith Hawton from the University of Oxford Centre for Suicide Research, also showed the risk is much higher for people living in socially deprived areas.

Previous research has shown that individuals who are bullied as children have a 3 times more likelihood of hurting themselves, especially if they have emotional distress, difficulty behaving during childhood, and a history in the family of people self-mutilating themselves. However, despite these alarming facts, parents still have different views on which bullying behaviors should be stopped by school officials.

The experts in the current study gathered and analyzed information on more than 30,000 people who sought emergency treatment after they self-injured or poisoned themselves at Manchester, Derby, and Oxford between 2000 and 2007.

An evaluation was made of the causes of premature death and years of life lost (YLL), and then compared with the general population. The scientists used residential post-codes to test whether socioeconomic deprivation was a factor.

During the median 6 year course of follow up, about 6% (1832) of patients passed away from natural and external causes (unintentional poisonings, and accidents other than poisoning). Analysis showed that these deaths, due to both natural and external causes, were significantly greater for both males and females, having an estimated 30 YLL by each person.

The most common cause of early death appeared to be accidental poisoning with a suicide following. Interestingly, deaths due to natural causes were 2 to 7.5 times greater than anticipated, with the biggest contributors being diseases of the digestive (mostly caused by alcohol) and circulatory systems and mental and behavioral disorders (87% resulted from psychoactive substance abuse).

The risk of premature death due to natural causes (but not external causes) was closely linked with socioeconomic status, which increased the more economically deprived a person was.

Hawton explained:

“Our study confirms that the increase in premature death among people who self-harm is not limited to suicide or other external causes, but includes dying prematurely from a wide variety of natural causes such as diseases of the circulatory and digestive systems which accounted for a third of deaths in our study. Our findings have significant public health implications, and emphasize the importance of assessing physical health as well as psychosocial problems as part of standard checks when individuals present with self-harm.”

Eric Caine from the University of Rochester Medical Center in the USA added:

“[This research highlights that] although review of risk and protective factors for imminent, potentially fatal suicide attempts is essential, assessment of the nature of people’s lives- ie, appraisal of the broad contexts of their actions, social and interpersonal struggles, behaviors, and basic medical problems- is equally important…[and] should encourage policy makers to look for new models of service delivery to meet patients’ diverse needs.”

Written by Sarah Glynn