Risk factors for dementia and self-harm: A linkage study.

People living with dementia experience poor mental health and high rates of self-harm. We investigated risk factors for self-harm in people aged > 40 years living with dementia and risk factors for dementia after self-harm. Using linked hospital data from New South Wales, Australia, we defined a dementia cohort (n = 154,811) and a self-harm cohort (n = 28,972). Using survival analyses, we investigated predictors of self-harm for the dementia cohort, and predictors of dementia for the self-harm cohort. We found self-harm or dementia diagnoses occurred most often within 24 months of a dementia diagnosis or initial self-harm presentation, respectively. Men living with dementia, and people with complex psychiatric profiles, had the greatest risk of self-harm. Men who had self-harmed had the greatest risk of dementia diagnoses. Men and people with complex psychiatric profiles and dementia may particularly benefit from post-diagnosis mental and behavioral support to reduce risk of self-harm.

Walker AR ，Srasuebkul P ，Trollor JN ，Wand APF ，Draper B ，Cvejic RC ，Moxey A ，Reppermund S ... -  《-》

Mortality in people living with dementia who self-harmed: An Australian data linkage study.

Walker AR ，Srasuebkul P ，Trollor JN ，Wand AP ，Draper B ，Cvejic RC ，Moxey A ，Reppermund S ... -  《-》

The survival and characteristics of older people with and without dementia who are hospitalised following intentional self-harm.

Characteristics of older people with and without dementia who are hospitalised following self-harm remains largely unexplored. This research compares the characteristics of older people with and without dementia who self-harm, compares associations of mental health-related diagnoses with those hospitalised for a self-harm and a non-self-harm injury and examines mortality by injury intent. A population-based study of individuals aged 50+ years with and without dementia admitted to hospital for a self-harm injury (and those with other injuries) using linked hospital admission and mortality records during 2003-2012 in New South Wales (NSW), Australia. Health outcomes, including hospital length of stay (LOS), 28-day readmission and 30-day and 12-month mortality were examined by dementia status. There were 427 hospitalisations of individuals with dementia and 11,684 hospitalisations of individuals without dementia following self-harm. The hospitalisation rate for self-harm for individuals with dementia aged 60+ years was double the rate for individuals without dementia (72.2 and 37.5 per 100,000). For both older people with and without dementia, those who self-harmed were more likely to have co-existent mental health and alcohol use disorders than individuals who had a non-self-harm injury. Individuals with dementia had higher 12-month mortality rates, 28-day readmission and longer LOS than individuals without dementia. Dementia is associated with an increased risk of hospitalisation for self-harm in older people and worse outcomes. The high rate of coexistent mental health conditions suggests that interventions which reduce behavioural and psychological symptoms of dementia might reduce self-harm in people with dementia. Copyright © 2016 John Wiley & Sons, Ltd.

Mitchell R ，Draper B ，Harvey L ，Brodaty H ，Close J ... -  《-》

Growth in emergency department self-harm or suicidal ideation presentations in young people: Comparing trends before and since the COVID-19 first wave in New South Wales, Australia.

Sara G ，Wu J ，Uesi J ，Jong N ，Perkes I ，Knight K ，O'Leary F ，Trudgett C ，Bowden M ... -  《-》

Physical, mental, and social wellbeing and their association with death by suicide and self-harm in older adults: a community-based cohort study.

To assess associations between physical, mental, and social well-being and suicide and self-harm in a community-based sample of older adults. Using a cohort design, questionnaire data from 102,880 individuals aged 65 years or older living in New South Wales, Australia during 2006-2009 were linked to hospital and cause-of-death databases until 2017. Poisson regressions obtained adjusted incidence rate ratios (IRRs). One hundred nine suicides and 191 deliberate self-harm (DSH) events occurred. Compared to those reporting excellent/good overall health, older adults reporting fair overall health had higher suicide rates (IRR = 2.8, 95% confidence interval: 1.8-4.4). Also, suffering from physical limitations was associated with higher rates of suicide. A fair versus excellent/good memory was associated with higher rates of suicide (IRR = 2.0, 1.3-3.3). Male erectile dysfunction was linked to self-harm (IRR = 2.8, 1.0-7.7). Suicide rates were elevated with baseline Kessler-10 scores of 20-50 versus 10-15 (IRR = 5.0, 2.9-8.9); the corresponding IRR for DSH was 2.9 (1.8-4.8). Elevated rates were observed for both self-reported depression and anxiety. Poor versus excellent/good quality of life was associated with suicide (IRR = 4.3, 1.7-10.7) and achieving less than desired to due to emotional problems was linked to self-harm (IRR = 1.8 1.3-2.4). Rates of suicide ande DSH were lower in those with ≥5 people to depend on versus one (suicide: IRR = 0.5, 0.3-0.9; DSH: IRR = 0.5, 0.3-0.7). Older adults experiencing health problems, including those relating to overall health or memory, and those with psychological distress had elevated rates of suicidal behavior. Rates of subsequent self-harm and/or death by suicide were elevated in participants with small social networks.

Erlangsen A ，Banks E ，Joshy G ，Calear AL ，Welsh J ，Batterham PJ ，Conwell Y ，Salvador-Carulla L ... -  《-》