Non-fatal self-harm in Scottish military veterans: a retrospective cohort study of 57,000 veterans and 173,000 matched non-veterans

Bergman, B. P., Mackay, D. F. , Smith, D. J. and Pell, J. P. (2019) Non-fatal self-harm in Scottish military veterans: a retrospective cohort study of 57,000 veterans and 173,000 matched non-veterans. Social Psychiatry and Psychiatric Epidemiology, 54(1), pp. 81-87. (doi:10.1007/s00127-018-1588-9) (PMID:30145625)

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Abstract

Purpose: Although suicide risk in veterans has been widely studied, there is little information on the risk of non-fatal self-harm in this population. We used data from the Scottish Veterans Health Study to conduct an epidemiological analysis of self-harm in veterans, in comparison with people who have never served. Methods: We conducted a retrospective, 30-year cohort study of 56,205 veterans born 1945–1985, and 172,741 people with no record of military service, and used Cox proportional hazard models to examine the association between veteran status and cumulative risk of non-fatal self-harm, overall and stratified by birth cohort, sex and length of service. We also examined mental and physical comorbidities, and association of suicide with prior self-harm. Results: There were 1620 (2.90%) first episodes of self-harm in veterans, compared with 4212 (2.45%) in non-veterans. The difference was statistically significant overall (unadjusted HR 1.27, 95% CI 1.21–1.35, p < 0.001). The risk was highest in the oldest veterans, and in the early service leavers who failed to complete initial training (unadjusted HR 1.69, 95% CI 1.50–1.91, p < 0.001). The risk reduced with longer service and in the intermediate birth cohorts but has increased again in the youngest cohort. Conclusions: The highest risk of non-fatal self-harm was in veterans with the shortest service, especially those who did not complete training or minimum engagement, and in the oldest birth cohorts, whilst those who had served the longest were at reduced risk. The risk has increased again in the youngest veterans, and further study of this subgroup is indicated.

Item Type:Articles
Status:Published
Refereed:Yes
Glasgow Author(s) Enlighten ID:Pell, Professor Jill and Bergman, Dr Beverly and Mackay, Dr Daniel and Smith, Professor Daniel
Authors: Bergman, B. P., Mackay, D. F., Smith, D. J., and Pell, J. P.
College/School:College of Medical Veterinary and Life Sciences > Institute of Health and Wellbeing > Mental Health and Wellbeing
College of Medical Veterinary and Life Sciences > Institute of Health and Wellbeing > Public Health
Journal Name:Social Psychiatry and Psychiatric Epidemiology
Publisher:Springer
ISSN:0933-7954
ISSN (Online):1433-9285
Published Online:25 August 2018
Copyright Holders:Copyright © 2018 The Authors
First Published:First published in Social Psychiatry and Psychiatric Epidemiology 54(1):81-87
Publisher Policy:Reproduced under a Creative Commons License
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