Background There is limited recent information regarding the risk of self-harm, somatic disorders and premature mortality following discharge from psychiatric hospital in young people. Objective To measure these risks in young people discharged from a psychiatric hospital as compared with both non-affected controls and non-hospitalised affected controls. Methods Data were extracted from the French national health records. Cases were compared with two control groups. Cases: all individuals aged 12–24 years, hospitalised in psychiatry in France in 2013–2014. Non-affected controls: matched for age and sex with cases, not hospitalised in psychiatry and no identification of a mental disorder in 2008–2014. Affected controls: unmatched youths identified with a mental disorder between 2008 and 2014, never hospitalised in psychiatry. Follow-up of 3 years. Logistic regression analyses were conducted with these confounding variables: age, sex, past hospitalisation for self-harm, past somatic disorder diagnosis. Findings The studied population comprised 73 300 hospitalised patients (53.6% males), 219 900 non-affected controls and 9 683 affected controls. All rates and adjusted risks were increased in hospitalised patients versus both non-affected and affected controls regarding a subsequent hospitalisation for self-harm (HR=105.5, 95% CIs (89.5 to 124.4) and HR=1.5, 95% CI (1.4 to 1.6)), a somatic disorder diagnosis (HR=4.1, 95% CI (3.9–4.1) and HR=1.4, 95% CI (1.3–1.5)), all-cause mortality (HR=13.3, 95% CI (10.6–16.7) and HR=2.2, 95% CI (1.5–3.0)) and suicide (HR=9.2, 95% CI (4.3–19.8) and HR=1.7, 95% CI (1.0–2.9)). Conclusions The first 3 years following psychiatric hospital admission of young people is a period of high risk for self-harm, somatic disorders and premature mortality. Clinical implications Attention to these negative outcomes urgently needs to be incorporated in aftercare policies. Data may be obtained from a third party and are not publicly available. This administrative data is only available through request from the French National System of Health Data (‘Système National des Données de Santé’, SNDS), which manages this sensitive information () and cannot be shared. Analysis outcomes can be obtained upon request immediately following publication for investigators whose proposed use of the data has been approved by an independent review committee (‘learned intermediary’) identified for this purpose. Purpose notably includes individual participant data meta-analysis. Proposals should be directed to the corresponding author.

中文翻译：

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青少年和年轻人精神病科住院后 3 年内的自我伤害、躯体疾病和死亡率

背景 关于年轻人从精神病院出院后的自残、躯体疾病和过早死亡风险的近期信息有限。目的 与未受影响的对照组和未住院的受影响对照组相比，衡量从精神病院出院的年轻人的这些风险。方法 从法国国家健康档案中提取数据。将病例与两个对照组进行比较。病例：所有 12-24 岁的人，2013-2014 年在法国住院接受精神病治疗。未受影响的对照：在 2008-2014 年期间与病例的年龄和性别相匹配，未住院接受精神病治疗且未发现精神障碍。受影响的对照：在 2008 年至 2014 年间被确定患有精神障碍的未匹配青年，他们从未在精神病院住院。随访 3 年。使用以下混杂变量进行逻辑回归分析：年龄、性别、过去因自伤住院、过去的躯体疾病诊断。结果 研究人群包括 73 300 名住院患者（53.6% 为男性）、219 900 名未受影响的对照组和 9 683 名受影响的对照组。与未受影响和受影响的对照组相比，住院患者的所有发生率和调整后风险均有所增加（HR=105.5，95% CI（89.5 至 124.4）和 HR=1.5，95% CI（1.4 至 124.4） 1.6)), 躯体疾病诊断 (HR=4.1, 95% CI (3.9–4.1) and HR=1.4, 95% CI (1.3–1.5)), 全因死亡率 (HR=13.3, 95% CI (10.6) –16.7) 和 HR=2.2, 95% CI (1.5–3.0)) 和自杀 (HR=9.2, 95% CI (4.3–19.8) 和 HR=1.7, 95% CI (1.0–2.9))。结论 年轻人精神病院入院后的前 3 年是自残、躯体障碍和过早死亡的高风险时期。临床意义迫切需要将对这些负面结果的关注纳入善后政策。数据可能从第三方获得，并且不公开。此管理数据只能通过法国国家卫生数据系统（“Système National des Données de Santé”，SNDS）的请求获得，该系统管理此敏感信息（) 且无法共享。分析结果可以根据要求在发布后立即获得，调查人员的数据使用建议已获得为此目的确定的独立审查委员会（“博学的中介”）的批准。目的尤其包括个体参与者数据元分析。提案应直接提交给相应的作者。