The association of physical illness and self-harm resulting in hospitalisation among older people in a population-based study

Abstract

Objectives: With population ageing, self-harm injuries among older people are increasing. Further examination of the association of physical illness and self-harm among older people is warranted. This research aims to identify the association of physical illness with hospitalisations following self-harm compared to non-self-harm injury among older people.

Method: A population-based cohort study of individuals aged 50+ years admitted to hospital either for a self-harm or a non-self-harm injury using linked hospital admission and mortality records during 2003–2012 in New South Wales, Australia was conducted. Logistic regression and survival plots were used to examine the association of 21 physical illnesses and mortality at 12 months by injury intent, respectively. Age-adjusted health outcomes, including length of stay, readmission and mortality were examined by injury intent.

Results: There were 12,111 hospitalisations as a result of self-harm and 474,158 hospitalisations as a result of non-self-harm injury. Self-harm compared to non-self-harm hospitalised injury was associated with higher odds of mental health conditions (i.e. depression, schizophrenia, bipolar and anxiety disorders), neurological disorders (excluding dementia), other disorders of the nervous system, diabetes, chronic lower respiratory disease, liver disease, tinnitus and pain. Tinnitus, pain, malignancies and diabetes all had a higher likelihood of occurrence for self-harm compared to non-self-harm hospitalisations even after adjusting for mental health conditions, number of comorbidities and alcohol and drug dependency.

Conclusion: Older people who are experiencing chronic health conditions, particularly tinnitus, malignancies, diabetes and chronic pain may be at risk of self-harm. Targeted screening may assist in identifying older people at risk of self-harm.

Keywords:

• self-harm
• older person
• chronic illness
• physical disease

Acknowledgements

This research was funded by the Dementia Research Collaborative Centres – Assessment and Better Care. The authors wish to thank the NSW Ministry of Health for providing access to the APDC, the NSW Registry of Births, Deaths and Marriages for providing access to mortality data, and the CHeReL for conducting the record linkage.

Disclosure statement

No potential conflict of interest was reported by the authors.

Additional information

Funding

The Dementia Research Collaborative Centres – Assessment and Better Care.