Depression and self-harm from adolescence to young adulthood in sexual minorities compared with heterosexuals in the UK: a population-based cohort study

ObjectivesTo compare population-based incidence rates of new-onset depression or self-harm in patients initiating incretin-based therapies with that of sulfonylureas (SU) and other glucose-lowering agents.DesignPopulation-based cohort study.SettingPatients attending primary care practices registered with the UK-based Clinical Practice Research Datalink (CPRD).ParticipantsUsing the UK-based CPRD, we identified two incretin-based therapies cohorts: (1) dipeptidyl peptidase-4 inhibitor (DPP-4i)-cohort, consisting of new users of DPP-4i and SU and (2) glucagon-like peptide-1 receptor agonists (GLP-1RA)-cohort, consisting of new users of GLP-1RA and SU, between January 2007 and January 2016. Patients with a prior history of depression, self-harm and other serious psychiatric conditions were excluded.Main outcome measuresThe primary study outcome comprised a composite of new-onset depression or self-harm. Unadjusted and adjusted Cox proportional hazards regression was used to quantify the association between incretin-based therapies and depression or self-harm. Deciles of High-Dimensional Propensity Scores and concurrent number of glucose-lowering agents were used to adjust for potential confounding.ResultsWe identified new users of 6206 DPP-4i and 22 128 SU in the DPP-4i-cohort, and 501 GLP-1RA and 16 409 SU new users in the GLP-1RA-cohort. The incidence of depression or self-harm was 8.2 vs 11.7 events/1000 person-years in the DPP-4i-cohort and 18.2 vs 13.6 events/1000 person-years in the GLP-1RA-cohort for incretin-based therapies versus SU, respectively. Incretin-based therapies were not associated with an increased or decreased incidence of depression or self-harm compared with SU (DPP-4i-cohort: unadjusted HR 0.70, 95% CI 0.51 to 0.96; adjusted HR 0.80, 95% CI 0.57 to 1.13; GLP-1RA-cohort: unadjusted HR 1.36, 95% CI 0.72 to 2.58; adjusted HR 1.25, 95% CI 0.63 to 2.50). Consistent results were observed for other glucose-lowering comparators including insulin and thiazolidinediones.ConclusionsOur findings suggest that the two incretin-based therapies are not associated with an increased or decreased risk of depression or self-harm.

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Depression and self-harm from adolescence to young adulthood in sexual minorities compared with heterosexuals in the UK: a population-based cohort study

European Journal of Public Health ◽

10.1093/eurpub/ckz185.138 ◽

2019 ◽

Vol 29 (Supplement_4) ◽

Author(s):

M Irish ◽

F Solmi ◽

B Mars ◽

M King ◽

G Lewis ◽

...

Keyword(s):

Mental Health ◽

Depressive Symptoms ◽

Young Adulthood ◽

Sexual Minority ◽

Sexual Minorities ◽

Multilevel Models ◽

Mental Health Problems ◽

Population Based ◽

Minority Adolescents ◽

Self Harm

Abstract Background There are few population-based cohort studies of the emergence, development, and persistence of mental health problems in sexual minorities compared with heterosexuals. We compared trajectories of depressive symptoms in sexual-minority adolescents and heterosexual adolescents from when they were aged 10 to 21 years, and examined self-harm at ages 16 and 21 years. Methods The study included 4828 adolescents born between April 1, 1991, and Dec 31, 1992, from the Avon Longitudinal Study of Parents and Children birth cohort (Bristol, UK) who reported their sexual orientation when aged 16 years. Depressive symptoms were assessed with the short Mood and Feelings Questionnaire at seven timepoints between ages 10 and 21 years. A self-harm questionnaire was completed at ages 16 and 21 years. Analyses were linear multilevel models with growth curves (depressive symptoms), logistic multilevel models (self-harm in the previous year at ages 16 and 21 years), and multinomial regression (lifetime self-harm with and without suicidal intent at age 21 years). Findings At age 10, depressive symptoms were higher in sexual minorities than in heterosexuals and increased with age to a larger extent. Depressive symptoms increased at each timepoint by 0·31 points in hetereosexuals, and by 0·49 points in sexual minorities. Sexual-minority adolescents were more likely than heterosexual adolescents to report self-harm in the previous year at ages 16 and 21 years, with no evidence that this estimate decreased with age. At aged 21, sexual minorities were more likely to report lifetime self-harm (ie, on at least one previous occasion) with suicidal intent than heterosexuals. Interpretation Mental health disparities between heterosexuals and sexual minorities are present early in adolescence and increase throughout the school years, persisting to young adulthood. Prevention of these mental health problems and early intervention must be a priority.

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The natural history of self-harm from adolescence to young adulthood: a population-based cohort study

The Lancet ◽

10.1016/s0140-6736(11)61141-0 ◽

2012 ◽

Vol 379 (9812) ◽

pp. 236-243 ◽

Cited By ~ 262

Author(s):

Paul Moran ◽

Carolyn Coffey ◽

Helena Romaniuk ◽

Craig Olsson ◽

Rohan Borschmann ◽

...

Keyword(s):

Cohort Study ◽

Natural History ◽

Young Adulthood ◽

Population Based ◽

History Of ◽

Self Harm

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Effects of the COVID-19 pandemic on primary care-recorded mental illness and self-harm episodes in the UK: a population-based cohort study

The Lancet Public Health ◽

10.1016/s2468-2667(20)30288-7 ◽

2021 ◽

Vol 6 (2) ◽

pp. e124-e135

Author(s):

Matthew J Carr ◽

Sarah Steeg ◽

Roger T Webb ◽

Nav Kapur ◽

Carolyn A Chew-Graham ◽

...

Keyword(s):

Primary Care ◽

Mental Illness ◽

Cohort Study ◽

Population Based ◽

Self Harm ◽

The Uk

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Self-harm presentation across healthcare settings by sex in young people: an e-cohort study using routinely collected linked healthcare data in Wales, UK

Archives of Disease in Childhood ◽

10.1136/archdischild-2019-317248 ◽

2019 ◽

Vol 105 (4) ◽

pp. 347-354 ◽

Cited By ~ 2

Author(s):

Amanda Marchant ◽

Samantha Turner ◽

Lloyd Balbuena ◽

Evyn Peters ◽

Dave Williams ◽

...

Keyword(s):

Primary Care ◽

Cohort Study ◽

Hospital Admissions ◽

Population Based ◽

Age Group ◽

Individual Level ◽

Healthcare Data ◽

Self Harm ◽

The Uk ◽

Over Time

BackgroundThis study used individual-level linked data across general practice, emergency departments (EDs), outpatients and hospital admissions to examine contacts across settings and time by sex for self-harm in individuals aged 10–24 years old in Wales, UK.MethodsA whole population-based e-cohort study of routinely collected healthcare data was conducted. Rates of self-harm across settings over time by sex were examined. Individuals were categorised based on the service(s) to which they presented.ResultsA total of 937 697 individuals aged 10–24 years contributed 5 369 794 person years of data from 1 January 2003 to 30 September 2015. Self-harm incidence was highest in primary care but remained stable over time (incident rate ratio (IRR)=1.0; 95% CI 0.9 to 1.1). Incidence of ED attendance increased over time (IRR=1.3; 95% CI 1.2 to 1.5) as did hospital admissions (IRR=1.4; 95% CI 1.1 to 1.6). Incidence in the 15–19 years age group was the highest across all settings. The largest increases were seen in the youngest age group. There were increases in ED attendances for both sexes; however, females are more likely than males to be admitted following this. This was most evident in individuals 10–15 years old, where 76% of females were admitted compared with just 49% of males. The majority of associated outpatient appointments were under a mental health specialty.ConclusionsThis is the first study to compare self-harm in people aged 10–24 years across primary care, EDs and hospital settings in the UK. The high rates of self-harm in primary care and for young men in EDs highlight these as important settings for intervention.

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Ethnic Differences in Self-Poisoning Across South London

Crisis ◽

10.1027/0227-5910/a000258 ◽

2014 ◽

Vol 35 (4) ◽

pp. 268-272

Author(s):

Sean Cross ◽

Dinesh Bhugra ◽

Paul I. Dargan ◽

David M. Wood ◽

Shaun L. Greene ◽

...

Keyword(s):

Black Women ◽

Data Collection ◽

White Women ◽

Population Based ◽

Care Services ◽

Self Harm ◽

Managing Risk ◽

The Uk ◽

Incident Cases ◽

Minority Ethnic

Background: Self-poisoning (overdose) is the commonest form of self-harm cases presenting to acute secondary care services in the UK, where there has been limited investigation of self-harm in black and minority ethnic communities. London has the UK’s most ethnically diverse areas but presents challenges in resident-based data collection due to the large number of hospitals. Aims: To investigate the rates and characteristics of self-poisoning presentations in two central London boroughs. Method: All incident cases of self-poisoning presentations of residents of Lambeth and Southwark were identified over a 12-month period through comprehensive acute and mental health trust data collection systems at multiple hospitals. Analysis was done using STATA 12.1. Results: A rate of 121.4/100,000 was recorded across a population of more than half a million residents. Women exceeded men in all measured ethnic groups. Black women presented 1.5 times more than white women. Gender ratios within ethnicities were marked. Among those aged younger than 24 years, black women were almost 7 times more likely to present than black men were. Conclusion: Self-poisoning is the commonest form of self-harm presentation to UK hospitals but population-based rates are rare. These results have implications for formulating and managing risk in clinical services for both minority ethnic women and men.

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Faculty Opinions recommendation of Changes in the incidence, prevalence and mortality of bronchiectasis in the UK from 2004 to 2013: a population-based cohort study.

Faculty Opinions – Post-Publication Peer Review of the Biomedical Literature ◽

10.3410/f.725917838.793530591 ◽

2017 ◽

Author(s):

Adam Hill

Keyword(s):

Cohort Study ◽

Population Based ◽

The Uk ◽

Incidence Prevalence

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Racial/Ethnic, Sex, Sexual Orientation, and Socioeconomic Disparities in Suicidal Trajectories and Mental Health Treatment Among Adolescents Transitioning to Young Adulthood in the USA: A Population-Based Cohort Study

Administration and Policy in Mental Health and Mental Health Services Research ◽

10.1007/s10488-021-01122-w ◽

2021 ◽

Cited By ~ 1

Author(s):

Yunyu Xiao ◽

Michael A. Lindsey

Keyword(s):

Mental Health ◽

Cohort Study ◽

Sexual Orientation ◽

Young Adulthood ◽

Mental Health Treatment ◽

Population Based ◽

Socioeconomic Disparities ◽

Health Treatment ◽

The Usa ◽

Racial Ethnic

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Persistence of Health Inequalities in Childhood Injury in the UK; A Population-Based Cohort Study of Children under 5

PLoS ONE ◽

10.1371/journal.pone.0111631 ◽

2014 ◽

Vol 9 (10) ◽

pp. e111631 ◽

Cited By ~ 21

Author(s):

Elizabeth Orton ◽

Denise Kendrick ◽

Joe West ◽

Laila J. Tata

Keyword(s):

Cohort Study ◽

Health Inequalities ◽

Population Based ◽

Childhood Injury ◽

The Uk ◽

Children Under 5

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Adolescent Police Stops, Self-Harm, and Attempted Suicide: Findings From the UK Millennium Cohort Study, 2012‒2019

American Journal of Public Health ◽

10.2105/ajph.2021.306434 ◽

2021 ◽

pp. e1-e9

Author(s):

Dylan B. Jackson ◽

Alexander Testa ◽

Rebecca L. Fix ◽

Tamar Mendelson

Keyword(s):

Cohort Study ◽

United Kingdom ◽

School Counselors ◽

Attempted Suicide ◽

Sociodemographic Factors ◽

Millennium Cohort Study ◽

The United Kingdom ◽

Self Harm ◽

Uk Millennium Cohort Study ◽

The Uk

Objectives. To explore associations between police stops, self-harm, and attempted suicide among a large, representative sample of adolescents in the United Kingdom. Methods. Data were drawn from the 3 most recent sweeps of the UK Millennium Cohort Study (MCS), from 2012 to 2019. The MCS is an ongoing nationally representative contemporary birth cohort of children born in the United Kingdom between September 2000 and January 2002 (n = 10 345). Weights were used to account for sample design and multiple imputation for missing data. Results. Youths experiencing police stops by the age of 14 years (14.77%) reported significantly higher rates of self-harm (incidence rate ratio = 1.52; 95% confidence interval [CI] = 1.35, 1.69) at age 17 years and significantly higher odds of attempted suicide (odds ratio = 2.25; 95% CI = 1.84, 2.76) by age 17 years. These patterns were largely consistent across examined features of police stops and generally did not vary by sociodemographic factors. In addition, 17.73% to 40.18% of associations between police stops and outcomes were explained by mental distress. Conclusions. Police-initiated encounters are associated with youth self-harm and attempted suicide. Youths may benefit when school counselors or social workers provide mental health screenings and offer counseling care following these events. (Am J Public Health. Published online ahead of print September 23, 2021: e1–e9. https://doi.org/10.2105/AJPH.2021.306434 )

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