scholarly journals Differences between medically treated and untreated non-fatal self-harm reported by hotline callers in China

PeerJ ◽  
2019 ◽  
Vol 7 ◽  
pp. e7868 ◽  
Author(s):  
Yongsheng Tong ◽  
Yi Yin ◽  
Nancy H. Liu
Keyword(s):  
Medical Treatment ◽  
Romantic Relationship ◽  
Psychological Services ◽  
The Self ◽  
Post Intervention ◽  
Relationship Problems ◽  
Wish To Die ◽  
Self Harm ◽  
Routine Assessment ◽  
Improve Access

Background Many self-harmers do not present in hospitals due to the self-harm. It is still unclear on the differences between medically treated and untreated self-harm in China. This study described the differences of the two groups of self-harmers using the largest psychological aid hotline data. Methods The present observational study recruited 3,403 hotline callers who reported episodes of self-harm before the call. In routine assessment, information about the most recent episode of self-harm was collected, including the method of self-harm, the wish to die, goals of the self-harm, and any medical treatment (irrespective of psychological services) in the hospital. The callers were divided into two groups: those who received hospital-based medical treatment due to the most recent self-harm (treated self-harm callers) and those who did not (untreated self-harm callers). Results In the most recent episode of self-harm, 65% (n = 2,217) of callers were untreated and 55% (1,226/2,217) of the untreated self-harm callers reported a wish to die. A total of 67% of the callers reported that their main goal of self-harm was to relieve suffering. The most common self-harm methods were using instruments (knife or rope) and overdosing on medicines. Compared with treated self-harm callers, the untreated self-harm callers were less likely to have a wish to die (OR = 0.57), engage in self-harm outside the home (OR = 0.71 and 0.78), and attribute their self-harm to romantic relationship problems (OR = 0.76); however, they were more likely to use instruments, to jump, or to choose other methods (OR = 3.73, 3.83, and 7.71, respectively). Conclusions Among hotline callers, many episodes of self-harm did not receive medical treatment, despite over half reporting a wish to die. Characteristics of self-harm behaviors were different between treated and untreated self-harm callers. Our findings suggest that more strategies should improve access to hospital-based medical treatment and coverage for post-intervention for self-harmers who are not presented in hospitals.

Self-harm in the very old one year later: has anything changed?

2019 ◽  
Vol 31 (11) ◽  
pp. 1559-1568 ◽  
Author(s):  
Anne Pamela Frances Wand ◽  
Brian Draper ◽  
Henry Brodaty ◽  
Carmelle Peisah
Keyword(s):  
General Practitioner ◽  
Community Services ◽  
The Self ◽  
Teaching Hospitals ◽  
Very Old ◽  
Inquiry Approach ◽  
Wish To Die ◽  
Self Harm ◽  
One Year

AbstractObjectives:To follow-up a cohort of older people who self-harmed, their carer, and general practitioner (GP) and examine their reflections on the self-harm, care experiences, and outcomes.Design:Qualitative in-depth interviews.Setting:Two teaching hospitals and associated community services.Participants:Twelve-month follow-up of participants aged 80 or older who self-harmed, their nominated carers, and GPs.Measurements:A geriatric psychiatrist gathered data through patient and carer interviews using a narrative inquiry approach and from medical records. Interviews were audio recorded and transcribed. N-VIVO facilitated data organization for thematic analysis. Questionnaires sent to the patient’s GP examined their perspectives and aspects of care relating to the self-harm.Results:Nineteen patients (63% baseline sample), 29 carers (90.6%), and 11 GPs (36.7%) were available at follow-up. Themes emerging from patients were “denial and secrets;” “endless suffering;” “more invalidation;” “being heard;” and “miserable in care.” Themes from carer interviews were “denial and secrets;” “patient’s persistent wish to die;” “abandonment by clinicians;” “unending burden for the carer;” and “distress regarding placement.” General practitioner themes were “the problem is fixed;” “the troops have arrived;” and “I understand.”Conclusions:Factors contributing to self-harm persisted at follow-up. Positive and negative responses were identified in the older person’s system, highlighting areas for potential intervention. A conceptual framework for understanding self-harm in the very old was derived that emphasized the importance of understanding individual needs, the interpersonal context of the older person, and carer burden. Interventions should improve communication, facilitate shared understanding of perspectives, and provide support at all levels.

Suicide and the self-harm continuum: phenomenological and biochemical evidence

1992 ◽  
Vol 4 (2) ◽  
pp. 149-155 ◽  
Author(s):  
Barbara Stanley ◽  
Ronald Winchel ◽  
Avraham Molcho ◽  
Daphne Simeon ◽  
Michael Stanley
Keyword(s):  
The Self ◽  
Biochemical Evidence ◽  
Self Harm

Investigating the “Self” in Deliberate Self-Harm

2005 ◽  
Vol 15 (10) ◽  
pp. 1293-1309 ◽  
Author(s):  
Joanna Adams ◽  
Karen Rodham ◽  
Jeff Gavin
Keyword(s):  
The Self ◽  
Deliberate Self Harm ◽  
Self Harm

Remodeling of the Paradoxical Middle Turbinate: Preserving Function While Gaining Access

2018 ◽  
Vol 32 (2) ◽  
pp. 98-100
Author(s):  
Ryan H. Belcher ◽  
Allison K. Ikeda ◽  
John M. DelGaudio
Keyword(s):  
Medical Treatment ◽  
Chronic Rhinosinusitis ◽  
Surgical Approach ◽  
Endoscopic Sinus Surgery ◽  
Middle Turbinate ◽  
Sinus Surgery ◽  
Middle Meatus ◽  
Anatomic Variant ◽  
And Function ◽  
Improve Access

Background Endoscopic sinus surgery is performed for many reasons, most commonly for chronic rhinosinusitis refractory to medical treatment. A paradoxical middle turbinate is an anatomic variant that can hinder endoscopic access to the sinuses. No publication has addressed how to surgically treat a paradoxical middle turbinate. Method We present a basic endoscopic surgical approach to conservatively resect a paradoxical middle turbinate in order to improve access to the middle meatus and the sinuses while preserving support and function. Conclusion Conservative remodeling of the paradoxical middle turbinate can provide access to the sinuses while maintaining a significant portion of the middle turbinate.

Testing the psychometric properties of the self-harm and suicide disclosure scale

2018 ◽  
Vol 270 ◽  
pp. 134-142 ◽  
Author(s):  
Laura M. Frey ◽  
George E. Higgins ◽  
Anthony Fulginiti
Keyword(s):  
Psychometric Properties ◽  
The Self ◽  
Self Harm

scholarly journals Repeated Enterocutaneous Fistula in a Munchausen Syndrome Patient

2019 ◽  
Vol 13 (1) ◽  
pp. 173-177
Author(s):  
Toshiaki Hagiwara ◽  
Shinya Munakata ◽  
Shun Ishiyama ◽  
Goto Michitoshi ◽  
Rina Takahashi ◽  
...  
Keyword(s):  
Enterocutaneous Fistula ◽  
The Self ◽  
Munchausen Syndrome ◽  
Rare Type ◽  
Wound Site ◽  
Fistula Surgery ◽  
Self Mutilation ◽  
Japanese Male ◽  
Old Japanese ◽  
Self Harm

Munchausen syndrome is a rare type of mental disorder in which the patient fakes illness to gain attention and sympathy. Patients may lie about symptoms, make themselves appear sick, or make themselves purposely unwell. We describe a case of repeated enterocutaneous fistula in Munchausen syndrome. A 53-year-old Japanese male was admitted to our hospital for the treatment of a high-flow enterocutaneous fistula. Surgery was performed two times, but the fistula recurred each time. Chopsticks with blood on them were coincidentally detected in the trash in the patient’s room. It was revealed that the enterocutaneous fistula was caused by self-mutilation. A psychiatrist was consulted, and the patient was diagnosed with Munchausen syndrome. The psychiatrist initiated treatment and the patient admitted the self-harm. His prolonged wound site was closed and he was able to be discharged. There has been no recurrence of the self-harm as of this writing, 3 years later. The treatment of Munchausen syndrome is difficult and early detection is important.

Prediction and network modelling of self-harm through daily self-report and history of self-injury

2020 ◽  
pp. 1-11 ◽  
Author(s):  
Michael J. Kyron ◽  
Geoff R. Hooke ◽  
Andrew C. Page
Keyword(s):  
Risk Factors ◽  
Psychological Distress ◽  
Daily Basis ◽  
Adverse Outcomes ◽  
Self Report ◽  
Public Health Issue ◽  
Short Term ◽  
Wish To Die ◽  
History Of ◽  
Self Harm

Abstract Background Self-harm is a significant public health issue, and both our understanding and ability to predict adverse outcomes are currently inadequate. The current study explores how preventative efforts could be aided through short-term prediction and modelling of risk factors for self-harm. Methods Patients (72% female, Mage = 40.3 years) within an inpatient psychiatric facility self-reported their psychological distress, interpersonal circumstances, and wish to live and die on a daily basis during 3690 unique admissions. Hierarchical logistic regressions assessed whether daily changes in self-report and history of self-harm could predict self-harm, with machine learning used to train and test the model. To assess interrelationships between predictors, network and cross-lagged panel models were performed. Results Increases in a wish to die (β = 1.34) and psychological distress (β = 1.07) on a daily basis were associated with increased rates of self-harm, while a wish to die on the day prior [odds ratio (OR) 3.02] and a history of self-harm (OR 3.02) was also associated with self-harm. The model detected 77.7% of self-harm incidents (positive predictive value = 26.6%, specificity = 79.1%). Psychological distress, wish to live and die, and interpersonal factors were reciprocally related over the prior day. Conclusions Short-term fluctuations in self-reported mental health may provide an indication of when an individual is at-risk of self-harm. Routine monitoring may provide useful feedback to clinical staff to reduce risk of self-harm. Modifiable risk factors identified in the current study may be targeted during interventions to minimise risk of self-harm.

scholarly journals Harm minimisation after repeated self-harm: development of a trust handbook

2008 ◽  
Vol 32 (2) ◽  
pp. 60-63 ◽  
Author(s):  
Nicky Pengelly ◽  
Barry Ford ◽  
Paul Blenkiron ◽  
Steve Reilly
Keyword(s):  
The Self ◽  
Service Users ◽  
Harm Minimisation ◽  
Suicidal Intent ◽  
Self Help ◽  
Self Injury ◽  
Safe Limits ◽  
Self Harm ◽  
Voluntary Organisations ◽  
Effective Treatments

Repeated self-harm without suicidal intent occurs in approximately 2% of adults (Meltzer et al, 2002). Service users report that professionals can respond to self-harm with unhelpful attitudes and ineffective care. Although evidence for effective treatments is poor (Hawton et al, 1999), this therapeutic pessimism is not found in the self-help approaches promoted by voluntary organisations such as Mind: ‘If you feel the need to self-harm, focus on staying within safe limits' (Harrison & Sharman, 2005). User websites frequently offer advice on harm minimisation: ‘Support the person in beginning to take steps to keep herself safe and to reduce her self-injury – if she wishes to. Examples of very valuable steps might be: taking fewer risks (e.g. washing implements used to cut, avoiding drinking if she thinks she is likely to self-injure)’ (Bristol Crisis Service for Women, 1997).

Suicide Prevention in New South Wales Correctional Centres

Crisis ◽  
1997 ◽  
Vol 18 (4) ◽  
pp. 163-169 ◽  
Author(s):  
Simon Eyland ◽  
Simon Corben ◽  
Jenny Barton
Keyword(s):  
Suicide Prevention ◽  
Preventive Measures ◽  
New South ◽  
New South Wales ◽  
The Self ◽  
Prevention Measures ◽  
South Wales ◽  
Self Harm ◽  
Incarcerated Population

The New South Wales Department of Corrective Services has introduced a number of suicide prevention measures in order to deal with the problem of inmate suicides. This article describes the measures. The article also shows that the characteristics of the incarcerated population differ greatly from those in the community. Findings from the self-harm database 1991-1995 show that, nevertheless, there are some unique characteristics of the group of self-harmers and fatal self-harmers. These findings are discussed in relation to the preventive measures that are introduced in the NSW correctional centers.

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