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Risk of suicide after a self-poisoning episode: a self-controlled case series study

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Social Psychiatry and Psychiatric Epidemiology Aims and scope Submit manuscript

Abstract

Purpose

The risk of death from suicide after self-poisoning has been known to be significantly higher as compared to the general population. Nevertheless, the change in suicide risk before and after self-poisoning is still unclear.

Methods

The database of territory-wide medical records collected by the Hospital Authority of Hong Kong was used to identify inpatients who have survived the first-ever self-poisoning but died by suicide between January 1, 2001, and December 31, 2010. A self-controlled case series (“SCCS”) design controlling for time-invariant patient confounders was used to explore the temporal change in suicide risk after the first self-poisoning episode.

Results

During the study period, 227 people in the database died from suicide after surviving one episode of self-poisoning. A significant increase of the risk of suicide in the first 12 months after the first lifetime self-poisoning—Risk Ratio (“RR”) 2.88 (95% CI 1.74–4.76)—was detected. The RR gradually returned to baseline levels after the second post-poisoning period.

Conclusion

By within-person comparison, the net increase of the suicide risk caused by the first self-poisoning was quantitatively modeled, demonstrating that the first lifetime self-poisoning event itself is a modifiable risk factor of subsequent suicide death.

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Notes

  1. https://github.com/zhongzhixu/SCCS.

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Authors and Affiliations

  1. School of Data Science, City University of Hong Kong, Hong Kong SAR, China

    Zhongzhi Xu, Jiannan Yang & Qingpeng Zhang

  2. Hong Kong Jockey Club Centre for Suicide Research and Prevention, The University of Hong Kong, Hong Kong SAR, China

    Zhongzhi Xu & Paul S. F. Yip

Authors
  1. Zhongzhi Xu
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  2. Jiannan Yang
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  3. Qingpeng Zhang
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  4. Paul S. F. Yip
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Corresponding authors

Correspondence to Qingpeng Zhang or Paul S. F. Yip.

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Xu, Z., Yang, J., Zhang, Q. et al. Risk of suicide after a self-poisoning episode: a self-controlled case series study. Soc Psychiatry Psychiatr Epidemiol 56, 2155–2162 (2021). https://doi.org/10.1007/s00127-021-02074-0

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  • DOI: https://doi.org/10.1007/s00127-021-02074-0

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