{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,2]],"date-time":"2026-08-02T06:58:09Z","timestamp":1785653889613,"version":"3.56.0"},"reference-count":39,"publisher":"Royal College of Psychiatrists","issue":"3","license":[{"start":{"date-parts":[[2025,3,27]],"date-time":"2025-03-27T00:00:00Z","timestamp":1743033600000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["cambridge.org"],"crossmark-restriction":true},"short-container-title":["Br J Psychiatry"],"published-print":{"date-parts":[[2026,3]]},"abstract":"<jats:sec id=\"S0007125025000224_as1\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Self-harm, self-poisoning or self-injury, irrespective of the motivation, is a central risk factor for suicide. Still, there is limited knowledge of self-harm among patients with substance use disorders (SUDs) who die by suicide.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S0007125025000224_as2\">\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>We aimed to describe the prevalence of a history of self-harm and identify the factors associated with self-harm, comparing individuals who died by suicide\u00a0with and without SUDs.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S0007125025000224_as3\">\n                    <jats:title>Method<\/jats:title>\n                    <jats:p>\n                      We used data from the Norwegian Surveillance System for Suicide in Mental Health and Substance Use Services, which is based on a national linkage between the Norwegian Cause of Death Registry and the Norwegian Patient Registry, to identify individuals who died by suicide within 1 year after last contact with mental health or substance use services (\n                      <jats:italic>n<\/jats:italic>\n                      = 1140). A questionnaire was retrieved for 1041 (91.3%) of these individuals. We used least absolute shrinkage and selection operator (LASSO) regression to select variables and compared patients with and without SUDs. Conditional selective inference was used to improve 90% confidence intervals and\n                      <jats:italic>p<\/jats:italic>\n                      -values.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S0007125025000224_as4\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The prevalence of self-harm was 55% in patients with SUDs and 52.6% in patients without SUDs. Suicidal ideation (odds ratio 2.98 (95% CI 1.74\u20135.10)) emerged as a factor shared with patients without SUDs, while personality disorders (odds ratio 1.96 (1.12\u20133.40)) and a history of violence (odds ratio 1.86 (1.20\u20132.87)) were unique factors for patients with SUDs.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S0007125025000224_as5\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>A history of self-harm is prevalent in patients with SUDs who die by suicide and is associated with suicidal ideation, a history of violence and personality disorders in patients with SUDs.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1192\/bjp.2025.22","type":"journal-article","created":{"date-parts":[[2026,2,17]],"date-time":"2026-02-17T09:30:52Z","timestamp":1771320652000},"page":"229-235","update-policy":"https:\/\/doi.org\/10.1017\/policypage","source":"Crossref","is-referenced-by-count":2,"title":["Factors associated with self-harm in patients with substance use disorders who died by suicide: national hybrid questionnaire registry study"],"prefix":"10.1192","volume":"228","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9349-8922","authenticated-orcid":false,"given":"Martin \u00d8.","family":"Myhre","sequence":"first","affiliation":[{"name":"University of Oslo"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5154-7397","authenticated-orcid":false,"given":"Fredrik A.","family":"Walby","sequence":"additional","affiliation":[{"name":"University of Oslo"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ole","family":"Klungs\u00f8yr","sequence":"additional","affiliation":[{"name":"University of Oslo"},{"name":"Oslo University Hospital"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J\u00f8rgen G.","family":"Bramness","sequence":"additional","affiliation":[{"name":"Oslo University Hospital"},{"name":"The Norwegian Institute of Public Health"},{"name":"UiT The Arctic University of Norway"},{"name":"Norwegian National Competency Centre for Drug Abuse and Mental Illness"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lars","family":"Mehlum","sequence":"additional","affiliation":[{"name":"University of Oslo"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"170","published-online":{"date-parts":[[2025,3,27]]},"reference":[{"key":"S0007125025000224_ref16","volume-title":"An Introduction to glmnet","author":"Hastie","year":"2023"},{"key":"S0007125025000224_ref23","doi-asserted-by":"publisher","DOI":"10.1111\/j.1530-0277.2006.00114.x"},{"key":"S0007125025000224_ref31","doi-asserted-by":"publisher","DOI":"10.1016\/S2215-0366(19)30402-X"},{"key":"S0007125025000224_ref20","unstructured":"20 Liu, K , Markovic, J , Tibshirani, R. More powerful post-selection inference, with application to the Lasso. arXiv [Preprint] 2018. Available from: http:\/\/arxiv.org\/abs\/1801.09037 [cited 27 May 2024]."},{"key":"S0007125025000224_ref3","doi-asserted-by":"publisher","DOI":"10.1017\/S0033291715001804"},{"key":"S0007125025000224_ref27","doi-asserted-by":"publisher","DOI":"10.1521\/pedi.18.3.226.35445"},{"key":"S0007125025000224_ref21","doi-asserted-by":"publisher","DOI":"10.1007\/978-3-319-24277-4"},{"key":"S0007125025000224_ref33","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpsychires.2021.10.017"},{"key":"S0007125025000224_ref2","volume-title":"Self-harm: Assessment, Management and Preventing Recurrence (Report No.: NG225)","year":"2022"},{"key":"S0007125025000224_ref14","doi-asserted-by":"publisher","DOI":"10.4045\/tidsskr.14.1065"},{"key":"S0007125025000224_ref36","doi-asserted-by":"publisher","DOI":"10.1192\/bjp.2018.27"},{"key":"S0007125025000224_ref34","doi-asserted-by":"publisher","DOI":"10.1186\/1472-6963-11-96"},{"key":"S0007125025000224_ref5","doi-asserted-by":"publisher","DOI":"10.1136\/ebmental-2022-300549"},{"key":"S0007125025000224_ref32","doi-asserted-by":"publisher","DOI":"10.1038\/s44220-023-00153-6"},{"key":"S0007125025000224_ref38","doi-asserted-by":"publisher","DOI":"10.1001\/jamapsychiatry.2023.4302"},{"key":"S0007125025000224_ref39","doi-asserted-by":"publisher","DOI":"10.1038\/s41398-024-02852-9"},{"key":"S0007125025000224_ref19","doi-asserted-by":"publisher","DOI":"10.1146\/annurev-statistics-100421-044639"},{"key":"S0007125025000224_ref28","doi-asserted-by":"publisher","DOI":"10.1192\/bjp.188.4.374"},{"key":"S0007125025000224_ref30","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2015-010538"},{"key":"S0007125025000224_ref25","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(24)01984-6"},{"key":"S0007125025000224_ref18","volume-title":"Introduction to Statistical Learning \u2013 with Applications in R","author":"James","year":"2023"},{"key":"S0007125025000224_ref13","volume-title":"NCISH","year":"2021"},{"key":"S0007125025000224_ref15","volume-title":"Aktivitetesdata for psykisk helsevern og tverrfaglig spesialisert rusbehandling 2021 [Activity Data for Mental Health and Interdisiplinary Specialized Substance Use Treatment 2021], Report No.: IS-3037","year":"2022"},{"key":"S0007125025000224_ref10","first-page":"2882","article-title":"Sex-specific risk profiles for suicide among persons with substance use disorders in Denmark","volume":"16","author":"Adams","year":"2020","journal-title":"Addiction"},{"key":"S0007125025000224_ref1","doi-asserted-by":"publisher","DOI":"10.1017\/S0033291703007943"},{"key":"S0007125025000224_ref35","doi-asserted-by":"publisher","DOI":"10.1111\/add.15357"},{"key":"S0007125025000224_ref6","doi-asserted-by":"publisher","DOI":"10.1002\/9781118903223"},{"key":"S0007125025000224_ref7","doi-asserted-by":"publisher","DOI":"10.1176\/appi.ajp.2020.20060864"},{"key":"S0007125025000224_ref8","doi-asserted-by":"publisher","DOI":"10.1111\/add.13788"},{"key":"S0007125025000224_ref22","doi-asserted-by":"publisher","DOI":"10.1037\/bul0000084"},{"key":"S0007125025000224_ref24","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0232242"},{"key":"S0007125025000224_ref9","doi-asserted-by":"publisher","DOI":"10.1017\/S0033291722002240"},{"key":"S0007125025000224_ref37","doi-asserted-by":"publisher","DOI":"10.1016\/S2215-0366(22)00232-2"},{"key":"S0007125025000224_ref12","doi-asserted-by":"publisher","DOI":"10.1177\/14604582231167439"},{"key":"S0007125025000224_ref17","doi-asserted-by":"publisher","DOI":"10.18637\/jss.v033.i01"},{"key":"S0007125025000224_ref26","unstructured":"26 National Clinical Programme for the Assessment and Management of Patients who Present to the Emergency Department (NCPSH). Self-Harm and Suicide-Related Ideation. Health Service Executive, 2024 (https:\/\/www.hse.ie\/eng\/about\/who\/cspd\/ncps\/self-harm-suicide-related-ideation\/)."},{"key":"S0007125025000224_ref11","volume-title":"The ICD-10 Classification of Mental and Behavioural Disorders: Clinical Descriptions and Diagnostic Guidelines","year":"2004"},{"key":"S0007125025000224_ref4","doi-asserted-by":"publisher","DOI":"10.1080\/13811118.2021.2006101"},{"key":"S0007125025000224_ref29","doi-asserted-by":"publisher","DOI":"10.1192\/bjo.2020.11"}],"container-title":["The British Journal of Psychiatry"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.cambridge.org\/core\/services\/aop-cambridge-core\/content\/view\/S0007125025000224","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,29]],"date-time":"2026-07-29T08:33:22Z","timestamp":1785314002000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.cambridge.org\/core\/product\/identifier\/S0007125025000224\/type\/journal_article"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,3,27]]},"references-count":39,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2026,3]]}},"alternative-id":["S0007125025000224"],"URL":"https:\/\/doi.org\/10.1192\/bjp.2025.22","relation":{},"ISSN":["0007-1250","1472-1465"],"issn-type":[{"value":"0007-1250","type":"print"},{"value":"1472-1465","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,3,27]]},"assertion":[{"value":"\u00a9 The Author(s), 2025. Published by Cambridge University Press on behalf of Royal College of Psychiatrists","name":"copyright","label":"Copyright","group":{"name":"copyright_and_licensing","label":"Copyright and Licensing"}},{"value":"This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (https:\/\/creativecommons.org\/licenses\/by\/4.0\/), which permits unrestricted re-use, distribution and reproduction, provided the original article is properly cited.","name":"license","label":"License","group":{"name":"copyright_and_licensing","label":"Copyright and Licensing"}},{"value":"This content has been made available to all.","name":"free","label":"Free to read"}]}}