scholarly journals Psychiatric and personality disorders in deliberate self-harm patients

2001 ◽  
Vol 178 (1) ◽  
pp. 48-54 ◽  
Author(s):  
Camilla Haw ◽  
Keith Hawton ◽  
Kelly Houston ◽  
Ellen Townsend
Keyword(s):  
Personality Disorder ◽  
Personality Disorders ◽  
Psychiatric Disorders ◽  
General Hospital ◽  
Representative Sample ◽  
Deliberate Self Harm ◽  
Common Diagnosis ◽  
Icd 10 ◽  
Self Harm

BackgroundPrevious UK studies have reported much lower rates of psychiatric and personality disorder in those who attempt suicide than in those who die by suicide.AimsTo determine the nature and prevalence of psychiatric and personality disorders in deliberate self-harm (DSH) patients.MethodA representative sample of 150 DSH patients who presented to a general hospital were assessed using a structured clinical interview and a standardised instrument. Follow-up interviews were completed for 118 patients approximately 12–16 months later.ResultsICD–10 psychiatric disorders were diagnosed in 138 patients (92.0%), with comorbidity of psychiatric disorders in 46.7%. The most common diagnosis was affective disorder (72.0%). Personality disorder was identified in 45.9% of patients interviewed at follow-up. Comorbidity of psychiatric and personality disorder was present in 44.1%.ConclusionsPsychiatric and personality disorders, and their comorbidity, are common in DSH patients. This has important implications for assessment and management.

scholarly journals CLINICAL PROFILE AND PSYCHIATRIC MORBIDITY IN PATIENTS WITH DELIBERATE SELF-HARM

2020 ◽  
Vol 4 (1) ◽  
Author(s):  
Yogesh Motwani ◽  
Shobha Nair ◽  
Aditi Chaudhari ◽  
Kaustubh Mazumdar
Keyword(s):  
Psychiatric Disorder ◽  
Personality Disorders ◽  
Psychiatric Disorders ◽  
Demographic Data ◽  
Psychiatric Morbidity ◽  
Deliberate Self Harm ◽  
Icd 10 ◽  
History Of ◽  
Case Files ◽  
Self Harm

Background: It requires detailed research to understand the psychopathology behind DSH attempts. Apart from social factors, psychiatric disorders and individual coping mechanisms can contribute to DSH. This study will be helpful in knowing the prevalence of psychiatric morbidity in these patients. Aims and Objectives: To study the Psychiatric morbidity in patients with DSH. Materials and Methods: This is a retrospective, descriptive study including 42 patients who had history of DSH and were referred to psychiatry department of BARC Hospital, Mumbai. Patients who were below 45 years of age at the time of DSH and above 18 years at the time of study were included. Their socio-demographic data were collected, psychiatric diagnosis were noted from the case files, personality disorders were evaluated using ICD-10 IPDE. Data were analysed using descriptive and analytic statistical methods. Results: 42.86% of the population was diagnosed as having psychiatric disorder. Most common disorder was depression. 7.14% of the patients were diagnosed as having borderline personality disorder. Conclusions: Depression was the most common psychiatric disorder found in our study. Key words: Deliberate self-harm, psychiatric disorders, personality disorders.

Personality disorder and suicide

1997 ◽  
Vol 170 (5) ◽  
pp. 441-446 ◽  
Author(s):  
Andrew T. A. Cheng ◽  
A. H. Mann ◽  
K. A. Chan
Keyword(s):  
Personality Disorder ◽  
Personality Disorders ◽  
Psychiatric Disorders ◽  
Ethnic Groups ◽  
Severe Depression ◽  
Han Chinese ◽  
Main Category ◽  
Icd 10 ◽  
Emotionally Unstable Personality Disorder ◽  
Aboriginal Groups

BackgroundThe relationships between personality disorders and suicide were investigated among two aboriginal groups and the Han Chinese in East Taiwan.MethodBiographical reconstructive interviews were conducted for consecutive suicides from each of the three ethnic groups (116 suicides in total), 113 of whom were matched with two controls for age, gender, and area of residence.ResultsIn all three groups, a high proportion of suicides suffered from ICD-10 personality disorder before suicide (46.7–76.7%), and the most prevalent category was emotionally unstable personality disorder (F60.3) (26.7–56.7%). The risk for suicide was mainly significantly associated with F60.3, comorbidity among personality disorders, and comorbidity of personality disorder with other psychiatric disorders, particularly severe depression.ConclusionThe main category of personality disorder significantly associated with the risk of suicide is F60.3 in ICD-10. The risk is highest for a comorbidity of this category and severe depression.

THE TREATMENT OF DELIBERATE SELF-HARM IN BORDERLINE PERSONALITY DISORDER USING DIALECTICAL BEHAVIOUR THERAPY: A PILOT STUDY IN A HIGH SECURITY HOSPITAL

2001 ◽  
Vol 29 (1) ◽  
pp. 85-92 ◽  
Author(s):  
Gail Low ◽  
David Jones ◽  
Conor Duggan ◽  
Mick Power ◽  
Andrew MacLeod
Keyword(s):  
Borderline Personality Disorder ◽  
Personality Disorder ◽  
Suicide Ideation ◽  
Borderline Personality ◽  
Institutional Setting ◽  
Behaviour Therapy ◽  
Deliberate Self Harm ◽  
Dialectical Behaviour Therapy ◽  
Self Harm

Deliberate self-harm (DSH) presents a significant health problem, especially as treatments have not been particularly successful in reducing repetition. Dialectical behaviour therapy (DBT; Linehan, 1993) is one approach that has reported some success in reducing self-harm rates in borderline personality disorder patients, who self-harm frequently, though it remains largely untested outside its original setting. The present study aimed to assess the effectiveness of DBT in self-harming women in an institutional setting in the United Kingdom where self-harm is common. Female patients at Rampton Hospital who were displaying self-harming behaviour and met criteria for borderline personality disorder (N = 10) participated in the full one-year treatment package of DBT. Patients were assessed on self-harm rates and on a number of psychological variables, pre-, during- and post-therapy, including a 6-month follow-up. There was a significant reduction in DSH during therapy, which was maintained at 6-month follow-up. This was paralleled by a reduction in dissociative experiences and an increase in survival and coping beliefs, alongside improvements in depression, suicide ideation, and impulsiveness. The findings are preliminary but the results suggest that DBT might provide an effective treatment for severe self-harm in institutional settings, and also highlight some of the psychological mechanisms that might mediate these improvements in self-harming behaviour.

scholarly journals Suicide following deliberate self-harm: long-term follow-up of patients who presented to a general hospital

2003 ◽  
Vol 182 (6) ◽  
pp. 537-542 ◽  
Author(s):  
Keith Hawton ◽  
Daniel Zahl ◽  
Rosamund Weatherall
Keyword(s):  
General Hospital ◽  
Age Groups ◽  
First Year ◽  
Prevention Strategies ◽  
Deliberate Self Harm ◽  
Long Term Follow Up ◽  
Self Harm ◽  
Annual Risk

BackgroundDeliberate self-harm (DSH) is the strongest risk factor for future suicide. Up-to-date information on the extent of risk is lacking.AimsTo investigate the risk of suicide after DSH during a long follow-up period.MethodA mortality follow-up study to 2000 was conducted on 11583 patients who presented to hospital after DSH between 1978 and 1997. Data were obtained from a general hospital DSH register in Oxford and the Office for National Statistics, and from equivalent mortality registers in Scotland and Northern Ireland.ResultsThree hundred patients had died by suicide or probable suicide. The risk in the first year of follow-up was 0.7% (95% CI 0.6–0.9%), which was 66 (95% CI 52–82) times the annual risk of suicide in the general population. The risk after 5 years was 1.7%, at 10 years 2.4% and at 15 years 3.0%. The risk was far higher in men than in women (hazard ratio 2.8, 95% CI 2.2–3.6). In both genders it increased markedly with age at initial presentation.ConclusionsFollowing DSH there is a significant and persistent risk of suicide, which varies markedly between genders and age groups. Reduction in the risk of suicide following DSH must be a key element in national suicide prevention strategies.

scholarly journals General hospital presentations of non-fatal hanging over a 28-year period: case–control study

2008 ◽  
Vol 193 (6) ◽  
pp. 503-504 ◽  
Author(s):  
Keith Hawton ◽  
Helen Bergen ◽  
Deborah Casey ◽  
Sue Simkin
Keyword(s):  
Personality Disorder ◽  
General Hospital ◽  
Psychiatric Care ◽  
Case Control Study ◽  
Case Control ◽  
Suicidal Intent ◽  
Self Harm ◽  
Careful Assessment ◽  
Control Study

SummarySuicide by hanging and self-strangulation (‘hanging’) has become more common. We studied people who presented to hospital during a 28-year study period after using these methods for non-fatal self-harm. Hanging increased greatly in frequency during this time. The male:female ratio was nearly 3:1. Females were distinguished from males by far higher rates of psychiatric care, personality disorder and previous self-harm. Compared with matched individuals who presented with non-fatal self-poisoning, more of those who used hanging had high suicidal intent, fewer used alcohol in association with the act, and more subsequently died by suicide. They represent an important subgroup of those who self-harm, who require especially careful assessment and follow-up.

Deliberate Self-harm and Predictors of Out-patient Attendance

1987 ◽  
Vol 150 (2) ◽  
pp. 246-247 ◽  
Author(s):  
G. O'Brien ◽  
A. R. Holton ◽  
K. Hurren ◽  
L. Watt ◽  
F. Hassanyeh
Keyword(s):  
Personality Disorder ◽  
Psychiatric Treatment ◽  
Psychiatric Practice ◽  
Deliberate Self Harm ◽  
Self Harm ◽  
Psychiatric Intervention ◽  
Patient Attendance

Kreitman (1979) reported that up to one-half of patients given out-patient appointments one week after an episode of deliberate self-harm (DSH) fail to attend, and gave a number of possible explanations for this. Firstly, parasuicide is often the result of a crisis which may have resolved (albeit temporarily) by the end of a further week. Secondly, someone in a state of heightened tension may find one week too long to wait, and may resort to other strategies to deal with his problems. Thirdly, many parasuicides may find a psychiatric label unacceptable in the context of their problems, and fourthly, an appoint ment made for a fixed day and a fixed hour may not fit the need for immediate action which the subjects subculture had inculcated in him as a habit pattern. Morgan et al (1976) reported that up to 40% of their DSH patients either did not attend any appointment or failed to complete their treatment. Two possible explanations for this were that they either felt that they did not need psychiatric treatment, or else believed that psychiatric treatment was not an answer to their problems. Kessel and Lee (1962), probably in line with much psychiatric practice, did not give a follow-up appointment to 40% of their self-poisoners; this was for two reasons. Firstly, these patients did not have a problem for which psychiatric treatment was appropriate and secondly, many of these patients had an entrenched personality disorder, which made it unlikely that psychiatric intervention would be beneficial.

Assessment and Aftercare for Deliberate Self-Harm Patients Provided by a General Hospital Psychiatric Service

Crisis ◽  
2003 ◽  
Vol 24 (4) ◽  
pp. 145-150 ◽  
Author(s):  
Camilla Haw ◽  
Keith Hawton ◽  
Linda Whitehead ◽  
Kelly Houston ◽  
Ellen Townsend
Keyword(s):  
Open Access ◽  
General Hospital ◽  
Psychiatric Service ◽  
Deliberate Self Harm ◽  
Patients Satisfaction ◽  
Assessment And Treatment ◽  
Self Harm

Summary: We report on a sample of 135 deliberate self-harm (DSH) patients who were assessed by a general hospital DSH service, and on those who were offered aftercare by, or telephone open access to, the service. Patients' satisfaction with assessment and treatment, and their outcome were investigated at follow-up 12-20 months later. Four-fifths of patients reported the assessment following DSH to have been helpful and the assessor sympathetic. Thirty-three (24%) of the 135 patients assessed were offered treatment by the DSH service but 13 declined or failed to attend. Of the 20 who engaged in treatment, 17 (94%) were satisfied with their care. Open access to the DSH service by telephone was offered to 53 (39%) patients, nine (22%) of whom reported at follow-up that they had used this facility. A specialist DSH service can effectively assess and treat patients following DSH. It is important that the service is accessible and acceptable to patients.

A Psychiatric Liaison Service in a General Hospital Referrals and Their Appropriateness

1994 ◽  
Vol 39 (5) ◽  
pp. 141-144 ◽  
Author(s):  
D.J. Hall
Keyword(s):  
General Hospital ◽  
District General Hospital ◽  
Psychiatric Problem ◽  
Prior Training ◽  
Liaison Psychiatry ◽  
Deliberate Self Harm ◽  
Intensive Training ◽  
Psychiatric Referral ◽  
Self Harm

Referrals to a liaison psychiatry service, based in a District General Hospital, were studied over a six month period. 190 [89%] of the 214 referrals were for assessment following an episode of deliberate self harm. An excess of these referrals were male [57%] and a large proportion particularly of the males [36%] were diagnosed as having a significant alcohol problem. Many were felt to have no significant psychiatric problem [31%], and a large proportion were discharged with no psychiatric follow-up [28%]. Patterns of diagnosis and disposal differed between the sexes. Referring junior medical staff when asked to give their opinions on the likely management and overall need for psychiatric referral of patients were found to reach reasonable agreement with the assessing psychiatrist, even without prior training, and to be more cautious in their assessment. In many centres the trend is towards selective referral of deliberate self harm patients, and this appears a safe and appropriate development which can be achieved without intensive training or major alterations to working patterns, and which will result in modest but important reductions in inappropriate referrals.

scholarly journals Psychiatric Comorbidities in Patients with Deliberate Self-Harm in a Tertiary Care Center

2014 ◽  
Vol 52 (193) ◽  
pp. 697-701 ◽  
Author(s):  
Subash Ghimire ◽  
Sagar Devota ◽  
Rasmita Budhathoki ◽  
Nidesh Sapkota ◽  
Akhilesh Thakur
Keyword(s):  
Psychiatric Disorders ◽  
Formal Education ◽  
Care Center ◽  
Tertiary Care ◽  
Tertiary Referral Centre ◽  
Premorbid Personality ◽  
Psychiatric Comorbidities ◽  
Deliberate Self Harm ◽  
Common Diagnosis ◽  
Self Harm

Introduction: Deliberate self-harm is one of the common psychiatric emergencies in medical practice. It has become a global health problem with rates increasing over time. This hospital based study may help in understanding the cause, methods and psychiatric comorbidities present in such patients. The aim of this study was to (i) study the relationship between major socio-demographic variables and deliberate self-harm (ii) evaluate methods and precipitating cause (iii) determine the nature and prevalence of psychiatric and personality disorders in deliberate-self harm patients.Methods: This retrospective observational study was performed on 200 cases of deliberate self-harm in a tertiary referral centre in Eastern Nepal by the data collected from the medical records of these patients. Various sociodemographic data and psychiatric comorbidities prevalent in them were analysed.Results: Majority of the suicide attempters (77%) were less than 35 years of age. The female-to-male ratio was 1.35:1. 76% of the patients had received formal education. Majority (73.5%) were married. By occupation, 38% were housewives and 25.5% were students. 72.5% of cases had consumed organophosphates/-chlorides. Interpersonal conflict (72%) was the major cause of DSH. ICD-10 psychiatric disorders were diagnosed in 37% of cases and premorbid personality problems were present in 20% of cases. The most common diagnosis was adjustment disorder (13.5%) followed by mood disorder (11%).Conclusions: Majority of DSH cases were of younger generation. Psychiatric disorders and comorbid personality problems are common in DSH patients. This has important implications for proper assessment and management.Keywords: Deliberate self-harm; Organophosphorous; Para suicide; Psychiatric co-morbidities.

scholarly journals Repetition of deliberate self-harm and subsequent suicide risk: Long-term follow-up study of 11 583 patients

2004 ◽  
Vol 185 (1) ◽  
pp. 70-75 ◽  
Author(s):  
Daniel Louis Zahl ◽  
Keith Hawton
Keyword(s):  
Relative Risk ◽  
Suicide Risk ◽  
Single Episode ◽  
Deliberate Self Harm ◽  
Young Females ◽  
Follow Up Study ◽  
Increased Risk ◽  
Self Harm

BackgroundRepetition of deliberate self-harm (DSH) is a risk factor for suicide. Little information is available on the risk for specific groups of people who deliberately harm themselves repeatedly.AimsTo investigate the long-term risk of suicide associated with repetition of DSH by gender, age and frequency of repetition.MethodA mortality follow-up study to the year 2000 was conducted on 11583 people who presented to the general hospital in Oxford between 1978 and 1997. Repetition of DSH was determined from reported episodes prior to the index episode and episodes presenting to the same hospital during the follow-up period. Deaths were identified through national registers.ResultsThirty-nine percent of patients repeated the DSH. They were at greater relative risk of suicide than the single-episode DSH group (2.24; 95% CI 1.77–2.84). The relative risk of suicide in the repeated DSH group compared with the single-episode DSH group was greater in females (3.5; 95% C11.3–2.4) than males (1.8; 95% C1 2.3–5.3) and was inversely related to age (up to 54 years). Suicide risk increased further with multiple repeat episodes of DSH in females.ConclusionsRepetition of DSH is associated with an increased risk of suicide in males and females. Repetition may be a better indicator of risk in females, especially young females.

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