Risk of Self-Harm Among Individuals Diagnosed With Endometriosis

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This study found that individuals diagnosed with endometriosis had a 42% higher risk of self-harm, overdose, or suicide compared to a matched control group, especially those without prior psychiatric care.

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This retrospective cohort study utilized linked administrative health data from Ontario, Canada, to investigate the association between a diagnosis of endometriosis and subsequent risk of self-harm. The researchers compared individuals diagnosed with endometriosis against those without the condition, adjusting for various sociodemographic and clinical confounders to isolate the impact of the disease. The analysis revealed that patients with endometriosis had a significantly elevated hazard ratio for self-harm events compared to the control group, even after accounting for mental health history and other comorbidities. This paper is centrally about endometriosis — specifically examining its psychological comorbidity and associated risk of self-harm among affected individuals.

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Abstract

Endometriosis is a chronic inflammatory condition that has been linked to mental health outcomes. We conducted a population-based, retrospective, matched cohort study using administrative health data (2010-2022) from Ontario, Canada, to assess the risk of self-harm, overdose, and suicide in patients with endometriosis, accounting for prior psychiatric utilization. The cohort included 56,053 patients with endometriosis and 112,106 individuals in a matched control group. The primary outcome was a composite of intentional self-harm, overdose, and suicide. Endometriosis was associated with a higher risk of the composite outcome (adjusted hazard ratio 1.42, 95% CI, 1.27-1.59), particularly among individuals with no or minimal prior psychiatric care. These findings highlight the importance of considering mental health needs for patients newly diagnosed with endometriosis.
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Department of Obstetrics and Gynecology, University of Saskatchewan, Saskatoon, Saskatchewan, the Department of Obstetrics and Gynecology, University of Toronto, and ICES, Toronto, the Department of Obstetrics and Gynecology, Queen's University, Kingston Health Sciences Center, Kingston, and the Department of Obstetrics and Gynecology, Trillium Health Partners, Institute for Better Health, Mississauga, Ontario, and the Department of Obstetrics and Gynecology, McGill University, Montreal, Quebec, Canada. Corresponding author: Peter Thiel, MD, MPH, Department of Obstetrics and Gynecology, University of Saskatchewan, Saskatoon, SK, Canada; [email protected]. This study was supported by ICES, which is funded by an annual grant from the Ontario Ministry of Health (MOH) and the Ministry of Long-Term Care (MLTC). This document used data adapted from the Statistics Canada Postal CodeOM Conversion File, which is based on data licensed from Canada Post Corporation, and/or data adapted from the Ontario Ministry of Health Postal Code Conversion File, which contains data copied under license from Canada Post Corporation and Statistics Canada. Parts of this material are based on data and/or information compiled and provided by CIHI and the Ontario Ministry of Health. The analyses, conclusions, opinions, and statements expressed herein are solely those of the authors and do not reflect those of the funding or data sources; no endorsement is intended or should be inferred. Parts or whole of this material are based on data and/or information compiled and provided by Immigration, Refugees and Citizenship Canada Permanent Resident (IRCC-PR) database current to September 2020. However, the analyses, conclusions, opinions and statements expressed in the material are those of the author(s), and not necessarily those of IRCC. Parts of this material are based on data and information provided by Ontario Health (OH). The opinions, results, views, and conclusions reported in this paper are those of the authors and do not necessarily reflect those of OH. No endorsement by OH is intended or should be inferred. Financial Disclosure Ally Murji has been on the advisory board and speaker bureau for AbbVie, Bayer, and Pfizer. Olga Bougie has been on the advisory board and speaker bureau for AbbVie, Bayer, and Pfizer. Maria P. Velez reports receiving consultancy fees from Ferring Pharmaceuticals. The other authors did not report any potential conflicts of interest. Each author has confirmed compliance with the journal's requirements for authorship. Peer reviews and author correspondence are available at https://links.lww.com/AOG/E267.

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Condition tags

endometriosis

MeSH descriptors

Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis

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