Background: Interpersonal violence is a leading cause of morbidity, with potentially severe adverse consequences for victims’ mental health. The presentation aims to provide empirical evidence on patients´ risks of psychiatric illness, deliberate self-harm and suicide after being treated for violence-related injuries.
Methods: Using nationwide longitudinal registry data from Norway, we identified all individuals (n=28,276) presenting to emergency services in 2010-2018 with a violent injury, along with sex- and age-matched control individuals from the general population. The outcomes of study interest included subsequent hospital presentation for psychiatric disorder and deliberate self-harm and death by suicide, observed through December 31, 2018. Rates of each outcome were compared between violence-injured patients and comparison individuals using stratified multivariable Cox regression models, controlling for sociodemographic characteristics as well as history of psychiatric treatment and deliberate self-harm.
Results: Violence-injured patients had substantially higher rates of subsequent psychiatric treatment (102.8 per 100,000 person-years) when compared to controls (26.9 per 100,000), even after accounting for covariates (HRadj: 2.36; 95% CI: 2.29-2.42). These patients also had substantially higher rates of DSH (946.7 per 100,000 person-years) and suicide death (74.5 per 100,000), compared to controls (90.0 and 15.2 per 100,000, respectively). The relative risks remained significantly higher even after accounting for covariates (HRadj for DSH: 5.11; 95% CI: 4.62-5.66; HRadj for suicide: 2.40; 95% CI: 1.78-3.24). While the associations of violence injury with psychiatric illness and DSH were comparably strong for men and women, the relatively elevated risks increased with age. Violence-injured patients were more often than the controls (20% vs 6%) to have a history of prior psychiatric treatment and these patients had the highest risks for deliberate self-harm and suicide.
Interpretation. Violence-injured patients experience significantly excess rates of psychiatric illness, deliberate self-harm and suicide death. These findings underscore the need of clinical and public health strategies targeting this vulnerable population.