TUESDAY, Oct. 16, 2018 (HealthDay News) — Most older adults who self-harm are not referred to mental health services, according to a study published online Oct. 15 in The Lancet Psychiatry.

Catharine Morgan, Ph.D., from Manchester University in the United Kingdom, and colleagues identified 4,124 adults aged 65 years and older with a self-harm episode ascertained from Read codes recorded during 2001 to 2014. The standardized incidence was calculated, and the frequency of psychiatric referrals and prescription of psychotropic medication after self-harm was examined in 2,854 adults with at least 12 months of follow-up.

The researchers found that during the 13-year period, the overall incidence of self-harm was 4.1 per 10,000 person-years, with stable gender-specific rates. Overall, 11.7 percent of the 2,854 adults were referred to mental health services after self-harm; 59.3 and 11.8 percent were prescribed an antidepressant and a tricyclic antidepressant, respectively. Relative to the comparison cohort, the prevalence of having previously diagnosed mental illness and prevalence of having a previous physical health condition was higher in the self-harm cohort (prevalence ratios, 2.10 and 1.20, respectively). During the first year, adults from the self-harm cohort died from unnatural causes an estimated 20 times more often than those in the comparison cohort. The self-harm cohort had a markedly increased risk for suicide (hazard ratio, 145.4).

“Health care professionals should take the opportunity to consider the risk of self-harm when an older person consults with other health problems,” the authors write.

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