scholarly journals Comparison of the assessment by doctors and nurses of deliberate self-harm

2003 ◽  
Vol 27 (2) ◽  
pp. 57-60 ◽  
Author(s):  
Sian Nerys Weston
Keyword(s):  
Mental Illness ◽  
Psychiatric Nurses ◽  
Deliberate Self Harm ◽  
Use Of Resources ◽  
Community Psychiatric ◽  
Significant Difference ◽  
Referral Practices ◽  
Self Harm ◽  
Doctors And Nurses

Aims and MethodTo compare the assessment by community psychiatric nurses and junior psychiatric doctors of individuals following deliberate self-harm (DSH) and, in particular, to elicit differences in referral practices and perceptions of mental illness. The health professionals involved completed questionnaires after carrying out DSH assessment.ResultsThere was a significant difference in referral patterns between doctors and nurses after DSH assessment. Doctors were significantly more likely to refer individuals for psychiatric follow-up which involved direct contact with other doctors (51 of 72 (71%) compared with 60 of 175 (34%)). Doctors were also significantly more likely than nurses to perceive individuals as having a mental illness (57 of 72 (79%) compared with 86 of 175 (49%)).Clinical ImplicationsFurther research is warranted to establish the precise reasons for these differences, and to determine whether the widespread introduction of nurse-led services is an effective and efficient use of resources.

scholarly journals Comparison of the assessment by doctors and nurses of deliberate self-harm

2003 ◽  
Vol 27 (02) ◽  
pp. 57-60
Author(s):  
Sian Nerys Weston
Keyword(s):  
Mental Illness ◽  
Psychiatric Nurses ◽  
Deliberate Self Harm ◽  
Use Of Resources ◽  
Community Psychiatric ◽  
Significant Difference ◽  
Referral Practices ◽  
Self Harm ◽  
Doctors And Nurses

Aims and Method To compare the assessment by community psychiatric nurses and junior psychiatric doctors of individuals following deliberate self-harm (DSH) and, in particular, to elicit differences in referral practices and perceptions of mental illness. The health professionals involved completed questionnaires after carrying out DSH assessment. Results There was a significant difference in referral patterns between doctors and nurses after DSH assessment. Doctors were significantly more likely to refer individuals for psychiatric follow-up which involved direct contact with other doctors (51 of 72 (71%) compared with 60 of 175 (34%)). Doctors were also significantly more likely than nurses to perceive individuals as having a mental illness (57 of 72 (79%) compared with 86 of 175 (49%)). Clinical Implications Further research is warranted to establish the precise reasons for these differences, and to determine whether the widespread introduction of nurse-led services is an effective and efficient use of resources.

scholarly journals Liaison psychiatry in detection and management of mental illness

1996 ◽  
Vol 20 (8) ◽  
pp. 466-469
Author(s):  
Margaret Semple ◽  
David Brown ◽  
Elizabeth Irvine
Keyword(s):  
Mental Illness ◽  
Mental Disorder ◽  
Alcohol Misuse ◽  
Psychiatric Service ◽  
Psychiatric Ward ◽  
Liaison Psychiatry ◽  
Deliberate Self Harm ◽  
General Psychiatry ◽  
Self Harm

Of 299 referrals to the Dundee general psychiatry liaison service over a six month period, deliberate self-harm (DSH) was the reason in 83%. An overdose was used in 94%, and alcohol misuse occurred in 56% of DSH episodes. Fifty-two per cent of referrals were followed up by the general psychiatry service; 31% of these were admitted directly to a psychiatric ward, 10% on a compulsory basis. At follow-up, 23% remained in contact with the Dundee psychiatric service. Twenty-three per cent of all patients referred to the Area Alcohol Service (AAS) were in contact with it six months later. Clearly, liaison psychiatry has a role in detection and management of significant mental disorder.

Cost-effectiveness of community psychiatric nurse or out-patient psychiatrist care of neurotic patients

1983 ◽  
Vol 13 (2) ◽  
pp. 407-416 ◽  
Author(s):  
S. P. Mangen ◽  
E. S. Paykel ◽  
J. H. Griffith ◽  
A. Burchell ◽  
P. Mancini
Keyword(s):  
Consumer Satisfaction ◽  
Public Expenditure ◽  
Direct Costs ◽  
Psychiatric Nursing ◽  
Psychiatric Nurses ◽  
Chronic Patients ◽  
Community Psychiatric ◽  
Significant Difference ◽  
The Mean

SYNOPSISIn a prospective controlled investigation chronic patients, the majority with neurotic conditions, were randomly allocated either to community psychiatric nurses (CPN) as the main therapist or to routine out-patient psychiatrist follow-up. There was no statistically significant difference in the mean public expenditure for the two modes of care. The direct costs of psychiatric care comprised a small proportion of total public expenditure and were initially greater in the nursing group. Subsequently, and over the whole 18-month study period, nursing was the cheaper option in terms of these direct costs. Clinical and social outcomes were comparable in both follow-up groups. Consumer satisfaction was significantly greater among CPN patients. On balance, these results confirm the benefit of community psychiatric nursing for this patient group.

Negative Life Events Associated With Deliberate Self-Harm in an African Population in Uganda

Crisis ◽  
2005 ◽  
Vol 26 (1) ◽  
pp. 4-11 ◽  
Author(s):  
E. Kinyanda ◽  
H. Hjelmeland ◽  
S. Musisi
Keyword(s):  
Life Events ◽  
Negative Life Events ◽  
Life Time ◽  
Later Life ◽  
Dose Effect ◽  
Deliberate Self Harm ◽  
Time Period ◽  
Significant Difference ◽  
Self Harm ◽  
Suicide Interventions

Abstract. Negative life events associated with deliberate self-harm (DSH) were investigated in an African context in Uganda. Patients admitted at three general hospitals in Kampala, Uganda were interviewed using a Luganda version (predominant language in the study area) of the European Parasuicide Study Interview Schedule I. The results of the life events and histories module are reported in this paper. The categories of negative life events in childhood that were significantly associated with DSH included those related to parents, significant others, personal events, and the total negative life events load in childhood. For the later-life time period, the negative life events load in the partner category and the total negative life events in this time period were associated with DSH. In the last-year time period, the negative life events load related to personal events and the total number of negative life events in this time period were associated with DSH. A statistically significant difference between the cases and controls for the total number of negative life events reported over the entire lifetime of the respondents was also observed, which suggests a dose effect of negative life events on DSH. Gender differences were also observed among the cases. In conclusion, life events appear to be an important factor in DSH in this cultural environment. The implication of these results for treatment and the future development of suicide interventions in this country are discussed.

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.

Management in hospital after attempted suicide

1979 ◽  
Vol 17 (20) ◽  
pp. 78-80
Keyword(s):  
At Risk ◽  
Mental Illness ◽  
Attempted Suicide ◽  
Hospital Doctor ◽  
Deliberate Self Harm ◽  
Assessment And Treatment ◽  
Self Harm

The patient who is in hospital after an episode of deliberate self-harm is at risk both of non-fatal repetition (20% in the following year) and of successful suicide later (1–2% in the next year).8 9 Most patients admitted to hospital after self-poisoning are under 25, living unharmoniously with others and nearly all show personality difficulties rather than mental illness.10 11 This article attempts to guide the hospital doctor in the assessment and treatment of such patients.

scholarly journals Background stressors and deliberate self-harm

2003 ◽  
Vol 27 (11) ◽  
pp. 411-415 ◽  
Author(s):  
Helen S. Keeley ◽  
Mary O'Sullivan ◽  
Paul Corcoran
Keyword(s):  
Life Events ◽  
Interpersonal Problems ◽  
Dysfunctional Family ◽  
Deliberate Self Harm ◽  
Monitoring Study ◽  
History Of ◽  
Self Harm ◽  
Background History ◽  
Prospective Monitoring

Aims and MethodIn this study we aimed to identify negative life events, especially those associated with repetition, in the background histories of patients in a 2-year prospective monitoring study of hospital-treated deliberate self-harm (DSH). Thematic analysis of the narratives recorded during assessment was used to produce general categories of life events.ResultsIn 3031 DSH episodes (n=2287 individuals), women reported more life events than men. Family and interpersonal problems were most commonly reported. Reporting a dysfunctional family of origin, a history of sexual abuse and the imprisonment of self or other were associated with repetition retrospectively and prospectively.Clinical ImplicationsThe background history of patients who harm themselves should be explored routinely on assessment in order to help establish risk of repetition and to determine appropriate follow-up.

Early predictors of deliberate self-harm among adolescents. A prospective follow-up study from age 3 to age 15

2006 ◽  
Vol 93 (1-3) ◽  
pp. 87-96 ◽  
Author(s):  
Andre Sourander ◽  
Minna Aromaa ◽  
Leena Pihlakoski ◽  
Antti Haavisto ◽  
Päivi Rautava ◽  
...  
Keyword(s):  
Deliberate Self Harm ◽  
Follow Up Study ◽  
Early Predictors ◽  
Self Harm

Hostility, hopelessness and deliberate self-harm: a prospective follow-up study

1990 ◽  
Vol 81 (3) ◽  
pp. 280-283 ◽  
Author(s):  
A. D. Brittlebank ◽  
A. Cole ◽  
F. Hassanyeh ◽  
M. Kenny ◽  
D. Simpson ◽  
...  
Keyword(s):  
Deliberate Self Harm ◽  
Follow Up Study ◽  
Self Harm
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