Abstract
PurposeThe prevalence of deliberate self-harm (DSH) is high in young adults. However, few studies have examined risk in this specific age group. We, therefore, examined the relative influence and interactive nature of a wide range of potential sociodemographic and sick leave related risk factors in young adults, aged 18–35 years, using Norwegian register data.MethodsAll subjects with at least one episode of hospital presentation for DSH registered in the Norwegian Patient Register during the period 2008–2013 were compared with age, gender and date matched population controls using a nested case–control design. The relative influence of factors and their interactions were assessed using conditional logistic regression and recursive partitioning models.Results9 873 study cases were compared to 186 092 controls. Socioeconomic status, marital status, sick leave and several demographic factors influenced risk for DSH. Specifically, low education (OR 7.44, 95% CI 6.82–8.12), current sick leave due to psychiatric disorders (OR 18.25, 95% CI 14.97–22.25) and being previously married (OR 3.83, 95% CI 3.37–4.36) showed the highest effect sizes. Importantly, there was an interaction between education and sick leave, where those with either low education and no sick leave (OR 13.33, 95% CI 11.66–15.23) or high education and sick leave (OR 18. 87, 95% CI 17.41–24.21) were the subgroups at highest risk.ConclusionDSH in young adults is associated with multiple sociodemographic and health disadvantages. Importantly, the two high-risk subgroups imply different pathways of risk and a need for differentiated preventative efforts.
Highlights
Young adults are overrepresented among those who present to clinical services after an episode of deliberate self-harm (DSH) [1,2,3]
While marriage has a protective effect in our analysis, our results suggest that its contribution to risk for DSH in young adults seem to be less important compared to the middle aged, which conforms to previous findings [50]
Our study added to existing literature by quantifying the relative influence and interactive nature of a wide range of risk factors on DSH in a large and representative sample of young adults
Summary
Young adults are overrepresented among those who present to clinical services after an episode of deliberate self-harm (DSH) [1,2,3]. Young adulthood is characterized by the transition into adult roles and responsibilities [5], where salient developmental tasks include education, workforce entrance and family formation. Failures in these tasks are major sources of distress [6, 7] and can mediate negative effects of preexisting vulnerabilities [8]. Proximal developmental factors have received less attention, despite being proven crucially important for the achievement of adult well-being and mental health [6, 7] Addressing how such transitions into adulthood influence
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