Death by suicide was defined as the act of intentionally ending one's own life (Nock et al., 2008) and was ascertained from death records using ICD 10 codes X60-X84 (intentional self-harm), Y10–34 (undetermined cause), as used by the UK Office for National Statistics (2019). Participants dying from other causes of death were censored at time of death.

Hospital admissions for self-harm were defined as any act of intentional self-poisoning or self-injury carried out by an individual, irrespective of the motivation or suicidal intent (National Collaborating Centre for Mental Health, 2011). This was assessed using the first admission for self-harm following attendance at the UK Biobank baseline assessment centre. Hospitalization for self-harm was assessed using ICD 10 codes X60 to-84 and Z91.5, for diagnosis and causes of admissions.

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