Adolescents and young adults who go to a hospital for treatment of self-harm may have an increased risk of developing a psychotic or bipolar disorder by the time they are 28 years old, a study in Schizophrenia Bulletin has found.
Koen Bolhuis, M.D., Ph.D., of the Royal College of Surgeons in Dublin, Ireland, and colleagues analyzed data from 59,476 people in the 1987 Finnish Birth Cohort study. The study comprises information from nationwide registers for all children who were born in Finland that year and includes data on inpatient care and outpatient visits at public hospitals. Bolhuis and colleagues followed individuals in the study from birth until the end of 2015, and the maximum age of people included in their study was 28 years.
Approximately 18% of people who visited a hospital for treatment of self-harm when they were between 11 and 28 years old went on to be diagnosed with a psychotic or bipolar disorder by the end of the study. People 21 years and younger had higher risk: 21% of those who were 18 to 21 years old and 29% of those who were younger than 18 years old at their first visit to the hospital for self-harm were diagnosed with a psychotic or bipolar disorder.
Overall, nearly 13% of the people who visited the hospital for treatment of self-harm went on to receive a diagnosis of psychosis, suggesting that they had more than six times the risk of developing psychosis compared with their peers who did not go to the hospital for self-harm. More than 9% visited the hospital for treatment of self-harm went on to receive a diagnosis of bipolar disorder, suggesting that they had nearly eight times the risk of developing bipolar disorder compared with their peers who did not go to the hospital for self-harm.
Bolhuis and colleagues noted that fewer than 1 in 10 adolescents who self-harm goes to the hospital because of their injuries. Therefore, the results of the study do not suggest that self-harm by itself increases the risk of psychotic or bipolar disorders. Rather, the findings suggest that going to the hospital for treatment of self-harm indicates a higher risk.
“[E]xisting health care systems (i.e., hospital registrations for self-harm) can be used as a strategy to identify individuals at elevated risk for psychosis and bipolar disorder,” the researchers wrote. “Our findings suggest that young people presenting to hospital emergency departments with self-harm should be carefully assessed for psychotic or bipolar disorders.”
For related information, see the Psychiatric Services article “Emergency Department Use and Inpatient Admissions and Costs Among Adolescents With Deliberate Self-Harm: A Five-Year Follow-Up Study.”
(Image: iStock/Boyloso)
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