Self-harm risk increased following ankylosing spondylitis diagnosis
medwireNews: Researchers have found an increased risk for self-harm in patients with ankylosing spondylitis (AS).
The study results showed that individuals with AS had a significant 59% increased risk for deliberate self-harm compared with individuals without the condition after taking into consideration many variables. The risk was also increased in patients with rheumatoid arthritis (RA), but not after adjustment for confounding factors.
The most common method of self-harm was poisoning, seen in 67% of AS patients. Presenting the findings at the EULAR 2018 meeting in Amsterdam, the Netherlands, Nigil Haroon (University of Toronto, Ontario, Canada) said this should be kept in mind given the multiple medications these patients receive as the mainstay of their treatment. Contact with a sharp object was the next common method, at a rate of 30%.
Administrative health data for Ontario were used to evaluate the 53,240 patients with RA and 13, 964 with AS, each of whom was matched to four individuals without inflammatory arthritis according to age, sex, and calendar year of diagnosis. None of the participants had a history of mental illness or a prior episode of deliberate self-harm.
Over the 15-year follow-up, while the cumulative incidence of deliberate self-harm events was significantly greater for patients with AS than for controls, Haroon notes that the actual number of patients who made attempts was relatively small, at 69, and so it is “quite rare, but still significant,” he said.
Indeed, he told medwireNews that “if you followed 300 [AS] patients over 10 years you might see two events.” This rarity makes it very difficult to find causation, he explained, “and this is probably why it is under-recognized.” He recommends screening for self-harm in these patients at the primary care level.
By Lucy Piper
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