Risk of Self-Harm Among Individuals Diagnosed With Endometriosis.

Thiel, Peter; Bougie, Olga; Pudwell, Jessica; Shellenberger, Jonas; Velez, Maria P; Murji, Ally · Obstet Gynecol · 2025

retrospective_cohort · Level III

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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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