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Widening Excess Mortality During the COVID-19 Pandemic in Individuals Who Self-Harmed

Sze Chim Lee, Marcos del Pozo Banos Orcid Logo, Yasmin Friedmann, Ashley Akbari Orcid Logo, Ronan Lyons Orcid Logo, Ann John Orcid Logo

Crisis, Volume: 45, Issue: 2

Swansea University Authors: Sze Chim Lee, Marcos del Pozo Banos Orcid Logo, Yasmin Friedmann, Ashley Akbari Orcid Logo, Ronan Lyons Orcid Logo, Ann John Orcid Logo

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DOI (Published version): 10.1027/0227-5910/a000882

Abstract

BackgroundStudies on COVID-19 pandemic-associated changes in mortality following self-harm remain scarce and inconclusive.AimsTo compare mortality risks in individuals’ who had self-harmed to those who had not, before and during the COVID-19 pandemic (Waves 1 and 2) in Wales, United Kingdom, using p...

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Published in: Crisis
ISSN: 0227-5910 2151-2396
Published: Hogrefe Publishing Group 2024
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Propensity score matching, Cox regression, and difference-in-differences were applied to compute changes in excess mortality (as ratios of hazard ratios, RHR) before and during the pandemic for individuals who self-harmed.ResultsThe difference in mortality for individuals who self-harmed compared to those who did not widened during Wave 1 (RHR = 2.0, 95% CI: 1.0-4.0) and Wave 2 (RHR = 2.2, 95% CI: 1.1-4.3) from before the pandemic. Stratification by sex and age group produced no significant subgroup differences although risk for &lt;65 years group were higher. LimitationsLimitations include small sample size and incomplete data on cause-specific deaths during the pandemic. ConclusionOur results underscore continuous monitoring of mortality of individuals who self-harm and effective interventions to address any increases in mortality.</abstract><type>Journal Article</type><journal>Crisis</journal><volume>45</volume><journalNumber>2</journalNumber><paginationStart/><paginationEnd/><publisher>Hogrefe Publishing Group</publisher><placeOfPublication/><isbnPrint/><isbnElectronic/><issnPrint>0227-5910</issnPrint><issnElectronic>2151-2396</issnElectronic><keywords/><publishedDay>1</publishedDay><publishedMonth>2</publishedMonth><publishedYear>2024</publishedYear><publishedDate>2024-02-01</publishedDate><doi>10.1027/0227-5910/a000882</doi><url/><notes/><college>COLLEGE NANME</college><department>Medical School</department><CollegeCode>COLLEGE CODE</CollegeCode><DepartmentCode>MEDS</DepartmentCode><institution>Swansea University</institution><apcterm/><funders>This work was supported by the Welsh Government through Health and Care Research Wales (Grant awarded to the National Centre for Mental Health, No. CA04; AJ, MDPB, and SCL) and by the Con-COV team funded by the Medical Research Council (Grant No. MR/V028367/1). This work was also supported by Health Data Research UK, which receives its funding from HDR UK Ltd (HDR-9006) funded by the UK Medical Research Council, Engineering and Physical Sciences Research Council, Economic and Social Research Council, Department of Health and Social Care (England), Chief Scientist Office of the Scottish Government Health and Social Care Directorates, Health and Social Care Research and Development Division (Welsh Government), Public Health Agency (Northern Ireland), British Heart Foundation (BHF), and the Wellcome Trust. This work was supported by the ADR Wales programme of work. The ADR Wales programme of work is aligned to the priority themes as identified in the Welsh Government’s national strategy: Prosperity for All. ADR Wales brings together data science experts at Swansea University Medical School, staff from the Wales Institute of Social and Economic Research, Data, and Methods (WISERD) at Cardiff University, and specialist teams within the Welsh Government to develop new evidence which supports Prosperity for All by using the SAIL Databank at Swansea University, to link and analyze anonymized data. ADR Wales is part of the Economic and Social Research Council (part of UK Research and Innovation) funded ADR UK (Grant ES/S007393/1). This work was supported by the Wales COVID-19 Evidence Centre, funded by Health and Care Research Wales.</funders><projectreference/><lastEdited>2024-09-11T11:35:03.7304873</lastEdited><Created>2022-07-13T15:48:52.6975562</Created><path><level id="1">Faculty of Medicine, Health and Life Sciences</level><level id="2">Swansea University Medical School - Medicine</level></path><authors><author><firstname>Sze Chim</firstname><surname>Lee</surname><order>1</order></author><author><firstname>Marcos</firstname><surname>del Pozo Banos</surname><orcid>0000-0003-1502-389X</orcid><order>2</order></author><author><firstname>Yasmin</firstname><surname>Friedmann</surname><order>3</order></author><author><firstname>Ashley</firstname><surname>Akbari</surname><orcid>0000-0003-0814-0801</orcid><order>4</order></author><author><firstname>Ronan</firstname><surname>Lyons</surname><orcid>0000-0001-5225-000X</orcid><order>5</order></author><author><firstname>Ann</firstname><surname>John</surname><orcid>0000-0002-5657-6995</orcid><order>6</order></author></authors><documents><document><filename>60486__25731__378e73b3050d4ff580077489ddc997db.pdf</filename><originalFilename>60486.pdf</originalFilename><uploaded>2022-11-10T15:45:48.3332308</uploaded><type>Output</type><contentLength>171236</contentLength><contentType>application/pdf</contentType><version>Version of Record</version><cronfaStatus>true</cronfaStatus><documentNotes>© 2022 The Author(s). 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spelling v2 60486 2022-07-13 Widening Excess Mortality During the COVID-19 Pandemic in Individuals Who Self-Harmed 10628af4988d624b49c4de7bd78b4694 Sze Chim Lee Sze Chim Lee true false f141785b1c0ab9efe45665d35c081b84 0000-0003-1502-389X Marcos del Pozo Banos Marcos del Pozo Banos true false 94dd4462b95e78880040791727786dfc Yasmin Friedmann Yasmin Friedmann true false aa1b025ec0243f708bb5eb0a93d6fb52 0000-0003-0814-0801 Ashley Akbari Ashley Akbari true false 83efcf2a9dfcf8b55586999d3d152ac6 0000-0001-5225-000X Ronan Lyons Ronan Lyons true false ed8a9c37bd7b7235b762d941ef18ee55 0000-0002-5657-6995 Ann John Ann John true false 2022-07-13 MEDS BackgroundStudies on COVID-19 pandemic-associated changes in mortality following self-harm remain scarce and inconclusive.AimsTo compare mortality risks in individuals’ who had self-harmed to those who had not, before and during the COVID-19 pandemic (Waves 1 and 2) in Wales, United Kingdom, using population-based routinely collected data.MethodWe linked whole population health data to all-cause mortality following an episode of self-harm between April 2016 and March 2021. Propensity score matching, Cox regression, and difference-in-differences were applied to compute changes in excess mortality (as ratios of hazard ratios, RHR) before and during the pandemic for individuals who self-harmed.ResultsThe difference in mortality for individuals who self-harmed compared to those who did not widened during Wave 1 (RHR = 2.0, 95% CI: 1.0-4.0) and Wave 2 (RHR = 2.2, 95% CI: 1.1-4.3) from before the pandemic. Stratification by sex and age group produced no significant subgroup differences although risk for <65 years group were higher. LimitationsLimitations include small sample size and incomplete data on cause-specific deaths during the pandemic. ConclusionOur results underscore continuous monitoring of mortality of individuals who self-harm and effective interventions to address any increases in mortality. Journal Article Crisis 45 2 Hogrefe Publishing Group 0227-5910 2151-2396 1 2 2024 2024-02-01 10.1027/0227-5910/a000882 COLLEGE NANME Medical School COLLEGE CODE MEDS Swansea University This work was supported by the Welsh Government through Health and Care Research Wales (Grant awarded to the National Centre for Mental Health, No. CA04; AJ, MDPB, and SCL) and by the Con-COV team funded by the Medical Research Council (Grant No. MR/V028367/1). This work was also supported by Health Data Research UK, which receives its funding from HDR UK Ltd (HDR-9006) funded by the UK Medical Research Council, Engineering and Physical Sciences Research Council, Economic and Social Research Council, Department of Health and Social Care (England), Chief Scientist Office of the Scottish Government Health and Social Care Directorates, Health and Social Care Research and Development Division (Welsh Government), Public Health Agency (Northern Ireland), British Heart Foundation (BHF), and the Wellcome Trust. This work was supported by the ADR Wales programme of work. The ADR Wales programme of work is aligned to the priority themes as identified in the Welsh Government’s national strategy: Prosperity for All. ADR Wales brings together data science experts at Swansea University Medical School, staff from the Wales Institute of Social and Economic Research, Data, and Methods (WISERD) at Cardiff University, and specialist teams within the Welsh Government to develop new evidence which supports Prosperity for All by using the SAIL Databank at Swansea University, to link and analyze anonymized data. ADR Wales is part of the Economic and Social Research Council (part of UK Research and Innovation) funded ADR UK (Grant ES/S007393/1). This work was supported by the Wales COVID-19 Evidence Centre, funded by Health and Care Research Wales. 2024-09-11T11:35:03.7304873 2022-07-13T15:48:52.6975562 Faculty of Medicine, Health and Life Sciences Swansea University Medical School - Medicine Sze Chim Lee 1 Marcos del Pozo Banos 0000-0003-1502-389X 2 Yasmin Friedmann 3 Ashley Akbari 0000-0003-0814-0801 4 Ronan Lyons 0000-0001-5225-000X 5 Ann John 0000-0002-5657-6995 6 60486__25731__378e73b3050d4ff580077489ddc997db.pdf 60486.pdf 2022-11-10T15:45:48.3332308 Output 171236 application/pdf Version of Record true © 2022 The Author(s). Distributed as a Hogrefe OpenMind article under the license CC BY 4.0 true eng https://creativecommons.org/licenses/by/4.0
title Widening Excess Mortality During the COVID-19 Pandemic in Individuals Who Self-Harmed
spellingShingle Widening Excess Mortality During the COVID-19 Pandemic in Individuals Who Self-Harmed
Sze Chim Lee
Marcos del Pozo Banos
Yasmin Friedmann
Ashley Akbari
Ronan Lyons
Ann John
title_short Widening Excess Mortality During the COVID-19 Pandemic in Individuals Who Self-Harmed
title_full Widening Excess Mortality During the COVID-19 Pandemic in Individuals Who Self-Harmed
title_fullStr Widening Excess Mortality During the COVID-19 Pandemic in Individuals Who Self-Harmed
title_full_unstemmed Widening Excess Mortality During the COVID-19 Pandemic in Individuals Who Self-Harmed
title_sort Widening Excess Mortality During the COVID-19 Pandemic in Individuals Who Self-Harmed
author_id_str_mv 10628af4988d624b49c4de7bd78b4694
f141785b1c0ab9efe45665d35c081b84
94dd4462b95e78880040791727786dfc
aa1b025ec0243f708bb5eb0a93d6fb52
83efcf2a9dfcf8b55586999d3d152ac6
ed8a9c37bd7b7235b762d941ef18ee55
author_id_fullname_str_mv 10628af4988d624b49c4de7bd78b4694_***_Sze Chim Lee
f141785b1c0ab9efe45665d35c081b84_***_Marcos del Pozo Banos
94dd4462b95e78880040791727786dfc_***_Yasmin Friedmann
aa1b025ec0243f708bb5eb0a93d6fb52_***_Ashley Akbari
83efcf2a9dfcf8b55586999d3d152ac6_***_Ronan Lyons
ed8a9c37bd7b7235b762d941ef18ee55_***_Ann John
author Sze Chim Lee
Marcos del Pozo Banos
Yasmin Friedmann
Ashley Akbari
Ronan Lyons
Ann John
author2 Sze Chim Lee
Marcos del Pozo Banos
Yasmin Friedmann
Ashley Akbari
Ronan Lyons
Ann John
format Journal article
container_title Crisis
container_volume 45
container_issue 2
publishDate 2024
institution Swansea University
issn 0227-5910
2151-2396
doi_str_mv 10.1027/0227-5910/a000882
publisher Hogrefe Publishing Group
college_str Faculty of Medicine, Health and Life Sciences
hierarchytype
hierarchy_top_id facultyofmedicinehealthandlifesciences
hierarchy_top_title Faculty of Medicine, Health and Life Sciences
hierarchy_parent_id facultyofmedicinehealthandlifesciences
hierarchy_parent_title Faculty of Medicine, Health and Life Sciences
department_str Swansea University Medical School - Medicine{{{_:::_}}}Faculty of Medicine, Health and Life Sciences{{{_:::_}}}Swansea University Medical School - Medicine
document_store_str 1
active_str 0
description BackgroundStudies on COVID-19 pandemic-associated changes in mortality following self-harm remain scarce and inconclusive.AimsTo compare mortality risks in individuals’ who had self-harmed to those who had not, before and during the COVID-19 pandemic (Waves 1 and 2) in Wales, United Kingdom, using population-based routinely collected data.MethodWe linked whole population health data to all-cause mortality following an episode of self-harm between April 2016 and March 2021. Propensity score matching, Cox regression, and difference-in-differences were applied to compute changes in excess mortality (as ratios of hazard ratios, RHR) before and during the pandemic for individuals who self-harmed.ResultsThe difference in mortality for individuals who self-harmed compared to those who did not widened during Wave 1 (RHR = 2.0, 95% CI: 1.0-4.0) and Wave 2 (RHR = 2.2, 95% CI: 1.1-4.3) from before the pandemic. Stratification by sex and age group produced no significant subgroup differences although risk for <65 years group were higher. LimitationsLimitations include small sample size and incomplete data on cause-specific deaths during the pandemic. ConclusionOur results underscore continuous monitoring of mortality of individuals who self-harm and effective interventions to address any increases in mortality.
published_date 2024-02-01T11:35:02Z
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score 11.037319

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