Impulsivity or Comorbidity in Bulimia Nervosa

1996 ◽  
Vol 169 (4) ◽  
pp. 451-458 ◽  
Author(s):  
Sarah L. Welch ◽  
Christopher G. Fairburn
Keyword(s):  
Bulimia Nervosa ◽  
Illicit Drugs ◽  
Community Sample ◽  
Sampling Bias ◽  
Drug Misuse ◽  
Control Group ◽  
Deliberate Self Harm ◽  
Self Harm ◽  
Diagnostic Subgroup ◽  
Normal Controls

BackgroundStudies showing high rates of alcohol and drug misuse and deliberate self-harm in bulimia nervosa have led some authors to call for a distinct diagnostic subgroup, sometimes termed “multi-impulsive bulimia”. However, these studies have been uncontrolled and of clinic samples and may be subject to sampling bias.MethodOne hundred and two women with DSM–III–R bulimia nervosa were compared with 204 normal controls and 102 controls with other psychiatric disorders, all recruited from the same community sample. Interview measures were used for diagnosis and for the assessment of alcohol and drug misuse and deliberate self-harm.ResultsBulimia nervosa cases did not differ from either of the control groups in terms of current alcohol consumption. Bulimia nervosa cases used more illicit drugs than either control group, but loss of control over drug use was very uncommon. Bulimia nervosa cases had a higher rate of deliberate self-harm than the controls. Only six (6%) bulimia nervosa cases had two or more of these behaviours concurrently.ConclusionSampling bias is present in clinic-based studies of comorbidity in bulimia nervosa. Those with comorbid substance misuse and deliberate self-harm are probably heterogeneous in character, and their classification as a subgroup would therefore be premature.

Deliberate Self-Harm Patients Who Discharge Themselves from the General Hospital Without Adequate Psychosocial Assessment

Crisis ◽  
2004 ◽  
Vol 25 (4) ◽  
pp. 183-186 ◽  
Author(s):  
Rachel Crowder ◽  
Rohan Van Der Putt ◽  
Ceri-Anne Ashby ◽  
Andrew Blewett
Keyword(s):  
General Hospital ◽  
Care Pathway ◽  
Alcohol Intoxication ◽  
Psychosocial Assessment ◽  
Hospital Environment ◽  
Control Group ◽  
Deliberate Self Harm ◽  
Increased Risk ◽  
Self Harm ◽  
Integrated Care Pathway

Abstract: Deliberate self-harm patients who leave the acute hospital environment before the completion of psychiatric assessment have an increased risk of subsequent self-harm. We considered the available data on 50 premature self-discharges identified prospectively in a general hospital with a well-developed integrated-care pathway for self-harm patients, and compared them to a control group. The self-discharge group was found to be more likely to have attempted self-poisoning without alcohol intoxication or other forms or combinations of self-harm, and an absence of identifiable previous self-harm or prior contact with local specialist psychiatric services. The two groups showed no difference in age, sex, or area of residence based on community mental health team sectors. It is proposed that these findings indicate hypotheses for further studies of why people leave the hospital without adequate assessment, and how service design could be improved in order to help them.

scholarly journals Depressive Symptoms and Deliberate Self-Harm in a Community Sample of Adolescents: A Prospective Study

2011 ◽  
Vol 2011 ◽  
pp. 1-11 ◽  
Author(s):  
Lars-Gunnar Lundh ◽  
Margit Wångby-Lundh ◽  
My Paaske ◽  
Stina Ingesson ◽  
Jonas Bjärehed
Keyword(s):  
Risk Factor ◽  
Depressive Symptoms ◽  
Longitudinal Design ◽  
Community Sample ◽  
Deliberate Self Harm ◽  
Self Image ◽  
Bidirectional Relationship ◽  
Self Harm ◽  
One Year ◽  
A Prospective Study

The associations between depressive symptoms and deliberate self-harm were studied by means of a 2-wave longitudinal design in a community sample of 1052 young adolescents, with longitudinal data for 83.6% of the sample. Evidence was found for a bidirectional relationship in girls, with depressive symptoms being a risk factor for increased self-harm one year later and self-harm a risk factor for increased depressive symptoms. Cluster analysis of profiles of depressive symptoms led to the identification of two clusters with clear depressive profiles (one severe, the other mild/moderate) which were both characterized by an overrepresentation of girls and elevated levels of self-harm. Clusters with more circumscribed problems were also identified; of these, significantly increased levels of self-harm were found in a cluster characterized by negative self-image and in a cluster characterized by dysphoric relations to parents. It is suggested that self-harm serves more to regulate negative self-related feelings than sadness.

Self-harm and substance use in a community sample of Black and White women with binge eating disorder or bulimia nervosa

2002 ◽  
Vol 32 (4) ◽  
pp. 389-400 ◽  
Author(s):  
Faith-Anne Dohm ◽  
Ruth H. Striegel-Moore ◽  
Denise E. Wilfley ◽  
Kathleen M. Pike ◽  
Julie Hook ◽  
...  
Keyword(s):  
Substance Use ◽  
Eating Disorder ◽  
Bulimia Nervosa ◽  
Binge Eating ◽  
Binge Eating Disorder ◽  
White Women ◽  
Community Sample ◽  
Black And White ◽  
Self Harm

Alcohol and drug abuse among persons with multiple sclerosis

2004 ◽  
Vol 10 (1) ◽  
pp. 35-40 ◽  
Author(s):  
C H Bombardier ◽  
K D Blake ◽  
D M Ehde ◽  
L E Gibbons ◽  
D Moore ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Substance Abuse ◽  
Alcohol Abuse ◽  
Illicit Drugs ◽  
Depressive Symptomatology ◽  
Community Sample ◽  
Alcohol Problems ◽  
Drug Misuse ◽  
Alcohol And Drug Abuse ◽  
The One

Objective: To examine the one-month prevalence and impact of substance abuse in a large community sample of persons with multiple sclerosis (MS). Method: Members of the Multiple Sclerosis Society of King C ounty were surveyed by mail. This multifaceted health survey included questions pertaining to substance abuse. Seven hundred and thirty-nine out of 1374 potential participants (54%) returned the survey, while 708 reported a medically confirmed diagnosis of MS and provided sufficient data. Results: Fourteen per cent of the sample screened positive for possible alcohol abuse or dependence, and 7.4% reported misusing illicit drugs or prescription medicatio ns within the previous month. Possible alcohol abuse and drug misuse were associated with younger age, less severe MS related disability and being employed, as well as greater self-reported depressive symptomatology. Most persons with alcohol problems indicated interest in learning more about ways to stop or cut down. Conclusions: Substance abuse may be present in up to 19% of this sample and contribute to high rates of depression. There may be greater risk of harm due to substance abuse in people with MS because of the potential magnification of motor and cognitive impairments. C omprehensive MS care should include substance abuse screening and advice to cut down or abstain.

scholarly journals Functional Disability in Psychiatric Patients With Deliberate Self-Harm as Compared to a Clinical Control Group

2021 ◽  
Vol 12 ◽  
Author(s):  
Magnus Nilsson ◽  
Lars-Gunnar Lundh ◽  
Åsa Westrin ◽  
Sofie Westling
Keyword(s):  
Cognitive Functioning ◽  
Functional Disability ◽  
Psychiatric Patients ◽  
World Health ◽  
Control Group ◽  
Deliberate Self Harm ◽  
The Past ◽  
Number Of Patients ◽  
Self Harm ◽  
The Impact

Background: Deliberate self-harm (DSH) is a common behavior in psychiatric populations. However, little is known regarding how DSH impacts daily life. The concept of functional disability, adopted by the World Health Organization (WHO), refers to the impact of disorders on six domains of daily functioning. The aim of the current study was to explore the functional disability of psychiatric patients with DSH as compared to a psychiatric control group.Methods: 32 psychiatric patients with DSH and 31 psychiatric patients without DSH were assessed with regards to demographic information, functional disability, psychiatric illness, DSH, general cognitive functioning, and measures of psychopathology. Group comparisons were made by means of t-tests, Mann-Whitney-tests, and Chi-square tests. Correlation analyses were done to assess the association between measures of psychopathology and functional disability.Results: The results indicated that patients with DSH had a lower ability to self-care as compared to the patients without DSH (p = 0.001, d = 0.90). Also, the patients with DSH reported a significantly higher number of days when they were totally unable to carry out usual activities in the past month (p = 0.008, d = 0.70) and that they were admitted in an inpatient setting significantly more days over the past year compared to the patients without DSH (p < 0.001, d = 0.58). The group with DSH was significantly younger (t = 3.00, p = 0.004) and reported significantly more BPD-symptoms (p = 0.013, d = 0.64) as well as higher current suicidality (p < 0.001, d = 1.32) compared to the group without DSH. The group with DSH also included a significantly higher number of patients diagnosed with borderline personality disorder (χ2 = 13.72, p < 0.001). There were no differences between the groups regarding general cognitive functioning or severity of depression. More research is needed to understand the underlying factors involved.

scholarly journals Religious beliefs, coping skills and responsibility to family as factors protecting against deliberate self-harm

2010 ◽  
Vol 16 (4) ◽  
pp. 9 ◽  
Author(s):  
K Kannan ◽  
S K Pillai ◽  
J S Gill ◽  
K O Hui ◽  
V Swami
Keyword(s):  
Protective Factors ◽  
Religious Beliefs ◽  
Coping Skills ◽  
Control Group ◽  
International Studies ◽  
Cross Sectional ◽  
Deliberate Self Harm ◽  
Self Harm ◽  
And Coping ◽  
And Control

<p><strong>Background.</strong> Deliberate self-harm (DSH) ranges from behaviours aiming to communicate distress or relieve tension, but where suicide is not intended, to actual suicide. Not all individuals are prone to DSH, which suggests that there are factors that protect against it. Identifying these could play an important role in the management and prevention of DSH.</p><p><strong>Objectives.</strong> This study examined whether religious beliefs, coping skills and responsibility to family serve as factors protecting against DSH in Kota Kinabalu, Sabah, Malaysia. <strong></strong></p><p><strong>Method.</strong> A cross-sectional comparative study assessed DSH patients consecutively admitted or directly referred to Queen Elizabeth General Hospital and Hospital Mesra Bukit Padang during the period December 2006 - April 2007. DSH patients (N=42) were matched with controls (N=42) for gender, age, religion, race, occupation and marital status. The DSH and control groups were compared using psychosocial tests that assess coping skills, religious beliefs and responsibility to family.</p><p><strong>Results.</strong> There were significant differences in religious beliefs (p=0.01) and responsibility to family (p=0.03) between the DSH patients and the control group. There were also significant differences in coping skills, DSH patients tending to use emotion-orientated coping (p=0.01) as opposed to task- and avoidance-orientated coping.<strong> </strong></p><p><strong>Conclusion.</strong> Consistent with international studies, coping skills (i.e. task-orientated skills), religious beliefs and responsibility to family were more evident in patients who did not attempt DSH than in those who did. These findings imply that treating DSH should not start only at the point of contact. Protective factors such as religious beliefs, responsibility to family and coping strategies can be inculcated from a very young age. However, caution is required in generalising the results owing to limitations of the study. Further extensive research on religious and psychotherapeutic interventions and prospective studies on protective factors will be helpful.</p>

The association between personality disorder and an act of deliberate self harm in the older person

2010 ◽  
Vol 23 (2) ◽  
pp. 299-307 ◽  
Author(s):  
C. W. Ritchie ◽  
M. B. King ◽  
F. Nolan ◽  
S. O'Connor ◽  
M. Evans ◽  
...  
Keyword(s):  
Personality Disorder ◽  
Odds Ratio ◽  
Control Group ◽  
Crude Odds Ratio ◽  
Younger Adults ◽  
Deliberate Self Harm ◽  
Specialist Services ◽  
Self Harm ◽  
Interaction With Age ◽  
Control Study

ABSTRACTBackground:Suicide rates are higher in the over 65s than in younger adults and there is a strong link between deliberate self harm (DSH) and suicide in older people. The association between personality disorder (PD) and DSH in older adults remains uncertain. Our objective was to describe this association.Methods:A case control study was conducted in which participants were: (i) those who had undertaken an act of DSH and (ii) a hospital-based control group drawn from a geographical contiguous population. PD was assessed using the Standardised Assessment of Personality (SAP)Results:Seventy-seven cases of DSH were identified; 61 (79.2%) of these participants were interviewed. There were 171 potential controls identified of whom 140 (81.9%) were included. An SAP was completed in 45/61 (73.8%) of cases and 100/140 (71.4%) of controls. The mean age was 79.8 years (SD = 9, range 65–103). The crude odds ratio for the association between PD and DSH was 5.91 [(95% CI 2.3, 14.9) p<0.0001]. There was a strong interaction with age stratified at 80 years. There was no association between PD and DSH after age 80. The adjusted odds ratio for PD in the group <80 years was 20.5 [(95% CI 3, 141) p = 0.002]. Borderline and impulsive PD traits tended to be associated with an episode of DSH more than other personality types.Conclusions:PD appears to be a strong and independent risk for an act of DSH in people aged between 65 and 80 years and should be looked for as part of any risk assessment in this population. Access to specialist services may be required to optimally manage this problem and reduce the subsequent risk of suicide.

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