Individual- and population-level associations of mental disorders with intentional self-harm

Background Registry-based studies can inform suicide prevention by identifying mental disorders with the highest risk. Previous studies focused on severe disorders and suicide, with limited data on non-lethal self-harm or population impact. We quantified individual- and population-level associations...

ver descrição completa

Detalhes bibliográficos
Autores: Mortier, P; Francisco, M; Alayo, I; Ballester, L; Martínez-Cerdá, JF; López, M; Diest, APV; Palao, D; Pérez-Solà, V; Mehlum, L; Kessler, RC; Plana-Ripoll, O; Vilagut, G; Alonso, J
Tipo de documento: Artigo
Estado:Published version
Data de publicação:2026
País:España
Recursos:Institut d'Investigació i Innovació Parc Taulí (I3PT)
Repositório:r-I3PT. Repositorio Institucional Producción Científica del Institut d'Investigació i Innovació Parc Taulí
OAI Identifier:oai:dnet:r-i3pt______::7c376a77187d1e42d70ccdaab0db51fe
Acesso em linha:https://i3pt.portalinvestigacion.com/publicaciones/7183
Nível de acesso:Acesso aberto
Palavra-chave:cohort studies
mental disorders
population attributable fraction
self-injurious behaviour
suicide
Descrição
Resumo:Background Registry-based studies can inform suicide prevention by identifying mental disorders with the highest risk. Previous studies focused on severe disorders and suicide, with limited data on non-lethal self-harm or population impact. We quantified individual- and population-level associations of 32 mental disorders with non-lethal intentional self-harm (NLISH) and suicide.Methods Registry-based cohort study representative for all residents of Catalonia (Spain) aged >= 10 years (2014-2019; n = 645,571). Cause-specific Cox models estimated individual (hazard ratios [HRs]) and population-level (population attributable fractions [PAFs]) associations with NLISH and suicide, stratified by sex and adjusted for age, socioeconomic status, and nationality.Results Individual-level associations with NLISH were strongest for borderline personality disorder (BPD; females HR = 26.9 [95%CI 24.9-29.0]; males HR = 18.9 [95%CI 16.7-21.4]). Associations with suicide were strongest for BPD in females (HR = 40.9 [95%CI 28.5-58.8]) and obsessive-compulsive disorder in males (HR = 17.4 [95%CI 5.3-56.5]). Associations with suicide were stronger among females, and those aged 10-44 across mood, substance use, dissociative, borderline personality, and psychotic disorders. Substantial proportions of outcomes were associated with common disorders: depressive episodes (PAFs 29.8-49.8%), substance use disorders (PAFs 25.1-48.7%), mixed anxiety-depressive disorders (PAFs 19.7-53.2%), and adjustment disorders (PAFs 10.6-44.6%).Conclusions Depressive, anxiety, adjustment, and substance use disorders are associated with large shares of self-harm and suicide, whereas BPD confers particularly high individual risk. Our findings support multilevel prevention strategies, especially among young people, including improved risk assessment, collaborative care, and timely access to specialized interventions.