Danish Suicide Prevention Clinics prevent more than deaths by suicide

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This post was written by Johannes Birkbak and Annette Erlangsen.

A new Danish study finds that psychosocial therapy for suicide prevention does more than preventing deaths by suicide. The treatment also reduces risk of death by other causes.

Mental and physical well-being are interrelated. People at risk of suicide have a considerably increased risk of dying, not only by suicide, but also by other causes of death.

A group of Danish researchers examined causes of death among nearly 6,000 persons who, following an episode of deliberate self-harm, received psychosocial therapy at one of the Danish Suicide Prevention Clinics. The group who received the intervention was compared to people receiving standard care following an episode of deliberate self-harm. Psychosocial therapy was associated with a 37% decrease in alcohol-related deaths as well as in deaths due to injuries and accidents. The risk of dying by a heterogeneous group of medical causes was reduced by 39%, while the risk of dying by suicide was reduced by 28%.

“This is the first European study to show improvements in mortality among persons who have received psychosocial therapy after deliberate self-harm. While we knew that the treatment in the Suicide Prevention Clinics does more than prevent suicidal behavior, we found it important to uncover what additional causes of death were prevented by the intervention,” says Johannes Birkbak, M.D., from the Danish Research Institute of Suicide Prevention, Mental Health Centre Copenhagen.

In conjunction with other research in this area, the results indicate that psychosocial therapy might enable patients to revise their coping strategies and, as a possible result, improve their general lifestyle, which might explain the mortality reductions.


About the study:

The study compares 5,678 people who received psychosocial therapy at a Suicide Prevention Clinic after an episode of deliberate self-harm with people who received standard care following an episode of deliberate self-harm. The multi-center study enrolled users from seven of the regional Suicide Prevention Clinics in Denmark during 1992-2011.

Using data from the national Danish registers, the researchers followed the treatment group and the control group for up to 20 years, and all deaths and causes of death were registered.

Given that the study evaluated an already established intervention after self-harm, it was not possible to randomise the patients. To account for this, a comparison group was selected to match the treatment group on 31 different factors using propensity score matching. The treatment group and the control group are comparable on factors such as age, sex, social background and clinical factors.

The study found that psychosocial therapy was associated with reduced risk of death by suicide, injuries and accidents, mental disorders, alcohol-related causes as well as a group of heterogeneous medical causes. Deaths caused by cancer and diseases of the circulatory system were not significantly reduced.

The study was designed and carried out by the Danish Research Institute for Suicide Prevention.

The full paper “Psychosocial therapy and causes of death after deliberate self-harm: a register-based, nationwide multicentre study using propensity score matching” by Johannes Birkbak, Elizabeth A Stuart, Bertel Dam Lind, Ping Qin, Elsebeth Stenager, Kim Juul Larsen, August G Wang, Ann Colleen Nielsen, Christian Møller Pedersen, Jan-Henrik Winsløv, Charlotte Langhoff, Charlotte Mühlmann, Merete Nordentoft, Annette Erlangsen can be read free of charge for a limited time here.

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