Suicide and non-suicide mortality after self-harm in Taipei City, Taiwan

BACKGROUND: Most previous studies of long-term mortality risk following self-harm have been conducted in Western countries with few studies from Asia. AIMS: To investigate suicide and non-suicide mortality after non-fatal self-harm in Taipei City, Taiwan. METHOD: Prospective cohort study (median follow-up 3.3 years) of 7601 individuals presenting to hospital with self-harm (January 2004 to December 2006). Standardised mortality ratios (SMRs) for suicide and non-suicide mortality were calculated. RESULTS: Suicide risk in the year following self-harm was over 100 times higher than in the general population (SMR = 119.6, 95% CI 99.6-142.5). Males and middle-aged and older adults had the highest subsequent risk of suicide. Compared with people who took an overdose, individuals who used hanging or charcoal burning in their index episode had the highest risk of suicide. For non-suicide mortality the SMRs were 6.7 (95% CI 5.7-7.8) in the first year and 4.4 (95% CI 3.9-4.9) during the whole follow-up period. CONCLUSIONS: Patterns of increased all-cause and suicide mortality following an episode of self-harm are similar in Taipei City to those seen in Western countries. Designing better aftercare following non-fatal self-harm, particularly for those with underlying physical disorders or who have used lethal self-harm methods, should be a priority for suicide prevention programmes in Asia.