# Self-harming behavior linked to earlier onset of cardiovascular disease in severe mental disorders

## TL;DR

People with severe mental disorders who engage in self-harming behaviors tend to develop cardiovascular disease earlier than those who do not.

## Contribution

This study identifies self-harming behavior as a novel predictor of earlier cardiovascular disease onset in individuals with severe mental disorders.

## Key findings

- Recurring self-harming behavior is linked to a shorter time to first cardiovascular disease diagnosis.
- More suicide attempts correlate with earlier cardiovascular disease onset in those with self-harming behavior.
- Age at mental disorder onset and substance use disorder were not significantly associated with cardiovascular disease timing.

## Abstract

People with severe mental disorders (SMDs) have about 15 years shorter life expectancy than the general population. Cardiovascular disease (CVD) is among the leading causes of premature mortality and shares genetic underpinnings with SMDs. We investigated the link between clinical traits in SMDs and time to the first CVD diagnosis.

The study included 1,627 well-characterized participants with schizophrenia spectrum (SCZ, N = 998) and bipolar spectrum disorders (BDs, N = 629), and a reference group of 1,201 healthy controls. CVD diagnoses were obtained from two Norwegian national registries (covering both primary and specialist health care) for the period of 2006–2020. Applying Cox proportional hazard models, we investigated associations between SMD clinical traits and time to first CVD diagnosis in SMD participants, adjusting for age, sex, diagnosis, and tobacco use.

Among individuals with SMD, recurring self-harming behavior (SHB) was associated with a shorter time to first CVD diagnosis (p = .029) relative to those without SHB. In the subgroup with SHB and a history of attempted suicide(s), more suicide attempts were associated with shorter time to first CVD diagnosis (p = .041). Significant associations of time to first CVD diagnosis with age at SMD onset and comorbid substance use disorder were not demonstrated.

SHB and a history of suicide attempts in individuals with SMD seem to be associated with earlier CVD onset, and may improve the prediction of CVD, in addition to standard cardiovascular risk factors.