Population Data Science, Swansea University Medical School, Swansea, UK.
Crisis. 2024 Mar;45(2):154-158. doi: 10.1027/0227-5910/a000882. Epub 2022 Oct 13.
Studies on COVID-19 pandemic-associated changes in mortality following self-harm remain scarce and inconclusive. To compare mortality risks in individuals who had self-harmed to those for individuals who had not, before and during the COVID-19 pandemic (Waves 1 and 2) in Wales, the United Kingdom, using population-based routinely collected data. We 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, RHRs) before and during the pandemic for individuals who self-harmed. The difference in mortality for individuals who self-harmed compared to those who did not widened during Wave 1 (RHR = 2.03, 95% CI: 1.04-4.03) and Wave 2 (RHR = 2.19, 95% CI: 1.12-4.29) from before the pandemic. Stratification by sex and age group produced no significant subgroup differences although risk for younger than 65 years group were higher. Limitations include small sample size and incomplete data on cause-specific deaths during the pandemic. Our results underscore continuous monitoring of mortality of individuals who self-harm and effective interventions to address any increases in mortality.
关于与 COVID-19 大流行相关的自伤后死亡率变化的研究仍然很少且没有定论。为了比较在 COVID-19 大流行（第 1 波和第 2 波）之前和期间，威尔士的英国，有过自伤行为的个体与没有自伤行为的个体的死亡率风险，我们使用基于人群的常规收集数据。我们将整个人群的健康数据与 2016 年 4 月至 2021 年 3 月期间发生自伤事件后的全因死亡率相关联。应用倾向评分匹配、Cox 回归和差分法，计算在大流行前和大流行期间有过自伤行为的个体的超额死亡率（以风险比的比值表示，RHR）的变化。与没有自伤行为的个体相比，在第 1 波（RHR = 2.03，95%CI：1.04-4.03）和第 2 波（RHR = 2.19，95%CI：1.12-4.29）期间，有过自伤行为的个体的死亡率差异扩大。按性别和年龄组分层没有产生显著的亚组差异，尽管 65 岁以下年龄组的风险更高。局限性包括样本量小和大流行期间死因特异性死亡数据不完整。我们的研究结果强调了对有过自伤行为的个体的死亡率进行持续监测，并采取有效干预措施解决任何死亡率上升的问题。
