Association Between Deliberate Self-harm and Violent Criminality

Sahlin, Hanna; Kuja‐Halkola, Ralf; Bjureberg, Johan; Lichtenstein, Paul; Molero, Yasmina; Rydell, Mina; Hedman, Erik; Runeson, Bo; Jokinen, Jussi; Ljótsson, Brjánn; Hellner, Clara

doi:10.1001/jamapsychiatry.2017.0338

Cited by 64 publications

(60 citation statements)

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“…Also, consistent with previous research (Beckman et al., ; Mars, Heron, Crane, Hawton, Lewis et al., ; Moran et al., ), only SH+SU was associated with a weaker connection with the labor market. Moreover, the link between SH and violence has previously been identified in another Swedish dataset (Sahlin et al., ). However, this study differentiates between SH and SH+SU in relation to violence, and our findings suggest that the previously reported increased risk for violence among self‐harming individuals may primarily be driven by co‐occurring SU, at least among adolescents.…”

Section: Discussionmentioning

confidence: 71%

“…For example, those with SH with suicidal intent have elevated odds of depression and anxiety, compared to those harming themselves without suicidal motives (Mars, Heron, Crane, Hawton, Kidger et al., ). SH with unclear intent has also been shown to be a risk factor of future suicide, affective and anxiety disorders, psychiatric inpatient care and psychotropic medication (Beckman et al., ), substance dependence (Beckman et al., ; Moran et al., ), violence (Sahlin et al., ), and labor market marginalization (Mars, Heron, Crane, Hawton, Lewis et al., ). To our best knowledge, there is only one longitudinal comparison between individuals with nonsuicidal and suicidal SH (Mars, Heron, Crane, Hawton, Lewis et al., ), showing that both groups were at increased risk of several adverse outcomes, but the suicidal SH group were generally at greater risk.…”

Section: Introductionmentioning

confidence: 99%

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Adolescent self‐harm with and without suicidality: cross‐sectional and longitudinal analyses of a Swedish regional register

Bjureberg

Ohlis

Ljótsson

et al. 2018

Child Psychology Psychiatry

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Section: Discussionmentioning

confidence: 71%

Section: Introductionmentioning

confidence: 99%

Adolescent self‐harm with and without suicidality: cross‐sectional and longitudinal analyses of a Swedish regional register

Bjureberg

Ohlis

Ljótsson

et al. 2018

Child Psychology Psychiatry

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“…Several reports suggest that a prompt therapeutic strategy should be considered to prevent aggressiveness in those patients with higher risk factors, such as severe manic, psychotic symptoms and lifetime history of self-aggressive behaviors (56,57). Taken together, these results claim for the need of an "anti-aggressive" treatment strategy in this subgroup of BD patients.…”

Section: Discussionmentioning

confidence: 90%

Aggressiveness in depression: a neglected symptom possibly associated with bipolarity and mixed features

Verdolini

Perugi

Samalin

et al. 2017

Acta Psychiatr Scand

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Objective: To evaluate aggressiveness during a major depressive episode (MDE) and its relationship with bipolar disorder (BD) in a post-hoc analysis of the BRIDGE-II-MIX study.Method: A total of 2,811 individuals were enrolled in this multicenter cross-sectional study. MDE patients with (MDE-A, n=399) and without aggressiveness (MDE-N, n=2,412) were compared through Chi-square test or Student's t-test. A stepwise backward logistic regression model was performed.Results: MDE-A group was more frequently associated with BD (p<0.001) whilst aggressiveness was negatively correlated with unipolar depression (p<0.001). At the logistic regression aggressiveness was associated with: the age at first depressive episode (p<0.001); the severity of mania (p=0.03); the diagnosis of BD (p=0.001); comorbid borderline personality disorder (BPD) (p<0.001) but not substance abuse (p=0.63); no current psychiatric treatment (p<0.001); psychotic symptoms (p=0.007); the marked social/occupational impairment (p=0.002). The variable most significantly associated with aggressiveness was the presence of DSM-5 mixed features (p<0.001, OR=3.815). After the exclusion of BPD, the variable of lifetime suicide attempts became significant (p=0.013, OR=1.405). Conclusion:Aggressiveness seems to be significantly associated with bipolar spectrum disorders, independently from BPD and substance abuse. Aggressiveness should be considered as a diagnostic criterion for the mixed features specifier and a target of tailored treatment strategy.Keys words: aggressiveness, bipolar disorder, DSM-5 mixed features specifier, major depressive episode 3 Significant outcomesIn this post-hoc analysis of the BRIDGE-II-MIX study, the presence of aggressive behaviors was mainly related with socio-demographic and clinical characteristics associated with bipolarity.

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“…We investigated self-harm and violent criminality as adverse outcomes because self-directed and externalised violence are associated harmful behaviours that share common causal factors. A Swedish national registry study from 2006 reported a five times increasd risk of violent crime conviction among people with a history of hospital-treated self-harm, with an independent doubled risk after adjustment for psychiatric comorbidity and environmental factors 9 . The combined societal costs of these two related deleterious behaviours are immense, 10 prompting calls for concerted action to tackle them in unison 11 …”

Section: Introductionmentioning

confidence: 99%

Self-harm and violent criminality among young people who experienced trauma-related hospital admission during childhood: a Danish national cohort study

Webb

Antonsen

Carr

et al. 2017

The Lancet Public Health

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SummaryBackgroundDevelopment of a better understanding of subsequent pathways for individuals who experienced trauma during childhood might usefully inform clinicians and public health professionals regarding the causes of self-harm and interpersonal violence. We aimed to examine these risks during late adolescence and early adulthood among people admitted to hospital following injuries or poisonings during their childhood.MethodsThis national cohort study included Danish people born between Jan 1, 1977, and Dec 31, 1997, and was linked to the National Patient Register and Psychiatric Central Research Register to identify all people exposed to hospital admissions for injuries or poisonings due to self-harm, interpersonal violence, or accidents before their 15th birthday. Linkage to these two registers and to the National Crime Register enabled ascertainment of self-harm and violent offending, respectively, as adverse outcomes at ages 15–35 years. Sex-specific incidence rate ratios (IRRs; relative risks) and cumulative incidence percentage values (absolute risks) were estimated. The confounding influence of parental socioeconomic status was also explored.Findings1 087 672 Danish people were included in this study. The prevalence of any trauma-related hospital admission was 10% (105 753 per 1 087 672; males: 64 454 [11%]; females: 44 299 [8%]) and for both sexes, accident was by far the most prevalent of the categories assessed (males: 59 011 [11%]; females: 40 756 [8%]). Similar patterns of increased risk for self-harm and violent criminality were observed in both sexes, although the IRRs were consistently and significantly larger in women (self-harm: IRR 1·94 [95% CI 1·85–2·02]; violent criminality: 2·16 [1·97–2·36]) than in men (self-harm: 1·61 [1·53–1·69]; violent criminality: 1·58 [1·53–1·63]). Confounding by parental socioeconomic status explained little of the increased risks observed. For young adult men, the highest absolute risk observed was for violent offending among individuals admitted to hospital for interpersonal violence injury during childhood (cumulative incidence 25·0% [95% CI 21·2–28·9]). For young adult women, absolute risk was highest for repeat self-harm among those admitted to hospital following self-harm during childhood (cumulative incidence 21·4% [95% CI 19·8–23·1]). More frequent trauma-related hospital admissions in childhood, and being admitted multiple times for more than one reason, conferred substantial risk increases among young people, with especially steep gradients of this nature observed among women.InterpretationTrauma-related hospital admission early in life could be a useful marker for childhood distress that subsequently predicts internalised and externalised destructive behaviours among youths and young adults and might provide a timely opportunity for initiating family-oriented interventions.FundingEuropean Research Council.

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Association Between Deliberate Self-harm and Violent Criminality

Abstract: Self-harm is associated with an increased risk of conviction for a violent offense in both sexes. The risk of violence, as well as the risk of suicide and self-harm, should be assessed among offending and self-harming individuals.

Cited by 64 publications

References 50 publications

Adolescent self‐harm with and without suicidality: cross‐sectional and longitudinal analyses of a Swedish regional register

Adolescent self‐harm with and without suicidality: cross‐sectional and longitudinal analyses of a Swedish regional register

Aggressiveness in depression: a neglected symptom possibly associated with bipolarity and mixed features

Self-harm and violent criminality among young people who experienced trauma-related hospital admission during childhood: a Danish national cohort study

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