Abstract
BackgroundDespite increasing awareness of high rates of physical illness and poor lifestyle behaviours among patients with a history of repeated deliberate self-harm (DSH), there is little research on specific lifestyle factors that are potentially problematic for this group. This paper aims to explore the relationship between lifetime repeated DSH and certain lifestyle factors, including balanced meals, eating breakfast, consumption of ‘junk’ food, weight, exercise, substance/alcohol use, smoking and social support, in a cohort of patients who presented to the Emergency Department (ED) with suicidal ideation or DSH.MethodsFrom 2007 to 2016, data from lifestyle and mental health measures were collected from 448 attenders at an outpatient clinic for DSH or suicidal ideation following ED presentation. Lifestyle behaviours (Fantastic Lifestyle Checklist) and mental health (Depression and Anxiety Stress Scale), clinical diagnosis and number of previous DSH episodes were measured on arrival. The associations between lifestyle variables and the number of lifetime DSH episodes were examined.ResultsSex, age, depression symptoms, poor diet, and smoking were all associated with a higher average number of deliberate self-harm episodes across the lifespan. There were non-significant positive trends for the other poor lifestyle behaviours. There was no association between DSH episodes and diagnosis of depression or anxiety disorder. In a multiple linear regression model, the only factors that remained significant were age, smoking and eating balanced meals, however, the relationship between smoking and lifetime DSH was moderated by more immediate DSH behaviours.ConclusionIn this sample of patients referred to a service following presentation to the ED with acute mental health concerns, balanced meals and smoking were the lifestyle behaviours that were found to have the strongest independent association with repeated DSH across the lifespan.
Highlights
Despite increasing awareness of high rates of physical illness and poor lifestyle behaviours among patients with a history of repeated deliberate self-harm (DSH), there is little research on specific lifestyle factors that are potentially problematic for this group
There was a significant effect for age, with younger age being associated with a higher number of DSH episodes (r = − 0.17, p < .01)
We focused on diet as an area of growing interest that has not been investigated in DSH groups and because the Fantastic Lifestyle Checklist (FLC) has a number of specific diet and dietrelated items along with a range of variables, including demographics, psychiatric diagnoses, and DASS scores gathered at their first visit
Summary
Despite increasing awareness of high rates of physical illness and poor lifestyle behaviours among patients with a history of repeated deliberate self-harm (DSH), there is little research on specific lifestyle factors that are potentially problematic for this group. Hawton et al [1] longitudinal follow up study of 11,583 patients presenting to a hospital ED found that is DSH associated with increased risk of death by suicide, and death from most natural causes, including respiratory disease, circulatory, neurological, endocrine, digestive, skin and musculoskeletal and connective tissue disorders. Another similar study [2] of 30, 950 presenters with DSH reported deaths due to natural causes were 2–7.5 times more frequent than in the general population.
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