Non-suicidal self-injury in adolescents: A diagnostic and psychopathological approach. A case presentation

2017 ◽  
Vol 41 (S1) ◽  
pp. S450-S450
Author(s):  
M.D. Ortega Garcia ◽  
V. Marti Garnica ◽  
S. Garcia Marin ◽  
C. Martinez Martinez ◽  
R. Gomez Martinez ◽  
...  
Keyword(s):  
Mental Health Center ◽  
Public Health Problem ◽  
Personal Characteristic ◽  
Family Characteristics ◽  
Major Public Health Problem ◽  
Case Presentation ◽  
Self Injury ◽  
Self Harm ◽  
Competing Interest ◽  
First Time

Self-injurious behavior is a major public health problem. An increase in the number of self-injuring adolescents has been observed since the mid-1960s.Description of clinical caseC. is a 14 teenager who comes to a mental health center for the first time a year ago for having numerous self-injuries in the forearm. She says that she cannot avoid doing so in moments of anxiety and that, in addition, when she is hurt she calms down. Throughout the interviews, C. relates that after the death of her best friend in a traffic accident she is alone and with episodes of anxiety.Exploration and complementary testsIt is important to analyze the risk factors of self-injurious behaviors in adolescence such as:– personal characteristic;– psychiatric disorders;– family characteristics;– mass media.DiagnosisDepressive episode (F32).Differential diagnosisIn general, self-injury is considered as a symptom or characteristic of a specific psychiatric disorder. Stereotyped self-injury is characteristic of processes of cognitive deficit of the level of severe and profound mental retardation. Compulsive self-harm involves symptomatic habits such as severe scratching of the skin or already differentiated psychiatric entities, such as trichotillomania, onicofagia or delusional parasitosis… Important psychotic disorder.ConclusionsFollowing the Task Force's criteria, in relation to probably effective therapies, it can be concluded that the therapy based on mentation for adolescents (MBT-A) is the first effective treatment for the treatment of self-harm in adolescents.Disclosure of interestThe authors have not supplied their declaration of competing interest.

scholarly journals Self-harm among in-school and street-connected adolescents in Ghana: a cross-sectional survey in the Greater Accra region

BMJ Open ◽  
2021 ◽  
Vol 11 (1) ◽  
pp. e041609
Author(s):  
Emmanuel Nii-Boye Quarshie ◽  
Farag Shuweihdi ◽  
Mitch Waterman ◽  
Allan House
Keyword(s):  
Public Health Problem ◽  
Self Report ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Self Injury ◽  
Significant Public Health Problem ◽  
Significant Public Health ◽  
Treatment Measures ◽  
Self Harm ◽  
Greater Accra Region

ObjectivesTo identify the prevalence, methods, associations and reported reasons for self-harm among in-school and street-connected adolescents in Ghana.DesignA cross-sectional survey. We applied multi-level regression models and model-based cluster analysis to the data.SettingThree contexts in the Greater Accra region were used: second cycle schools, facilities of charity organisations and street census enumeration areas (sleeping places of street-connected adolescents, street corners, quiet spots of restaurants, markets, train and bus stations, and lorry and car parks).ParticipantsA regionally representative sample of 2107 (1723 in-school and 384 street-connected) adolescents aged 13–21 years.Outcome measuresParticipants responded to a structured self-report anonymous questionnaire describing their experience of self-harm and eliciting demographic information and social and personal adversities.ResultsThe lifetime prevalence of self-harm was 20.2% (95% CI 19.0% to 22.0%), 12-month prevalence was 16.6% (95% CI 15.0% to 18.0%) and 1-month prevalence was 3.1% (95% CI 2.0% to 4.0%). Self-injury alone accounted for 54.5% episodes and self-poisoning alone for 16.2% episodes, with more than one method used in 26% of episodes. Self-cutting (38.7%) was the most common form of self-injury, whereas alcohol (39.2%) and medications (27.7%) were the most commonly reported means of self-poisoning. The factors associated with self-harm were interpersonal: conflict with parents (adjusted OR (aOR)=1.87, 95% CI 1.24 to 2.81), physical abuse victimisation (aOR=1.69, 95% CI 1.16 to 2.47), difficulty in making and keeping friends (aOR=1.24, 95% CI 0.85 to 1.80), sexual abuse victimisation (aOR=1.21, 95% CI 0.78 to 1.87) and conflict between parents (aOR=1.07, 95% CI 0.73 to 1.56).ConclusionsSelf-harm is a significant public health problem among in-school and street-connected adolescents in the Greater Accra region of Ghana. Its origins are very largely in social and familial adversity, and therefore prevention and treatment measures need to be focused in these areas.

Alcohol use and bipolar disorder comorbidity: Synthesis and perspectives

2017 ◽  
Vol 41 (S1) ◽  
pp. S470-S470
Author(s):  
A. Dahdouh ◽  
B. Semaoune ◽  
A. Tremey ◽  
L. Samalin ◽  
V. Flaudias ◽  
...  
Keyword(s):  
Bipolar Disorder ◽  
Alcohol Use ◽  
Dual Diagnosis ◽  
Public Health Problem ◽  
Major Public Health Problem ◽  
Systematic Screening ◽  
Electronic Search ◽  
Clinical Interest ◽  
Competing Interest ◽  
The Relationship

ObjectiveAlcohol use disorders and bipolar disorder commonly co-occur and both are associated with more pejorative outcomes, thus constituting a major public health problem. We undertook this synthetic review to provide an update on this issue in order to clarify the nature of the relationship between the two disorders, improve clinical outcomes, prevent complications and therefore optimize management of patients.MethodsWe conducted an electronic search by keywords in databases MEDLINE, EMBASE, PsychINFO, published in English and French from January1985 to December 2015.ResultsThe AUD prevalence is important among BD patients in whom the effects of alcohol are more severe. However, in terms of screening, it appears that the comorbidity is not systematically sought. The concept of co-occurrence finds its clinical interest in the development of specific screening and therapeutic strategies. To date, there are only few recommendations about the management of dual diagnosis and the majority of them support “integrated” approaches.ConclusionsRecommendations should emphasize this strong co-occurrence and promote systematic screening and offered integrated cares.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Exploring the Relationship Between Area Characteristics and Self-Harm

Crisis ◽  
2006 ◽  
Vol 27 (2) ◽  
pp. 88-91 ◽  
Author(s):  
Amy Johnston ◽  
Jayne Cooper ◽  
Navneet Kapur
Keyword(s):  
Public Health Problem ◽  
Multilevel Modelling ◽  
Major Public Health Problem ◽  
Ecological Studies ◽  
Descriptive Data ◽  
Individual Level ◽  
Self Harm ◽  
Multiple Levels ◽  
The Impact ◽  
The Relationship

Self-harm is strongly associated with later suicide and it is a major public health problem in its own right in many countries. There is a lack of evidence for effective individual level interventions following self-harm. Ecological studies examining the relationship between area characteristics and self-harm have yielded some interesting descriptive data but have had a number of limitations. Methodological and statistical developments in other fields of research may assist in building on findings to date. For example: The concept of social capital potentially provides a structure for examining sociocultural aspects of area; the use of more specific measures of locality will assist in studying area influences more fully; multilevel modelling may help to resolve the ecological fallacy through specifying variance attributable to factors at multiple levels simultaneously; areas in transition may provide natural conditions in which to investigate the impact of changing social environment. The potential utility of these new approaches is discussed with examples. Further investigation of the relationship between self-harm and area characteristics in a wide variety of settings may help to develop area-based interventions. Such interventions may have the potential to effect significant reductions in suicidal behavior.

Factors associated with deliberate self-harm among Irish adolescents

2010 ◽  
Vol 40 (11) ◽  
pp. 1811-1819 ◽  
Author(s):  
E. M. McMahon ◽  
U. Reulbach ◽  
P. Corcoran ◽  
H. S. Keeley ◽  
I. J. Perry ◽  
...  
Keyword(s):  
Life Style ◽  
Public Health Problem ◽  
Cross Sectional Study ◽  
Major Public Health Problem ◽  
Cross Sectional ◽  
Life Event ◽  
Deliberate Self Harm ◽  
Factors Associated ◽  
Related Risk ◽  
Self Harm

BackgroundDeliberate self-harm (DSH) is a major public health problem, with young people most at risk. Lifetime prevalence of DSH in Irish adolescents is between 8% and 12%, and it is three times more prevalent among girls than boys. The aim of the study was to identify the psychological, life-style and life event factors associated with self-harm in Irish adolescents.MethodA cross-sectional study was conducted, with 3881 adolescents in 39 schools completing an anonymous questionnaire as part of the Child and Adolescent Self-harm in Europe (CASE) study. There was an equal gender balance and 53.1% of students were 16 years old. Information was obtained on history of self-harm life events, and demographic, psychological and life-style factors.ResultsBased on multivariate analyses, important factors associated with DSH among both genders were drug use and knowing a friend who had engaged in self-harm. Among girls, poor self-esteem, forced sexual activity, self-harm of a family member, fights with parents and problems with friendships also remained in the final model. For boys, experiencing bullying, problems with schoolwork, impulsivity and anxiety remained.ConclusionsDistinct profiles of boys and girls who engage in self-harm were identified. Associations between DSH and some life-style and life event factors suggest that mental health factors are not the sole indicators of risk of self-harm. The importance of school-related risk factors underlines the need to develop gender-specific initiatives in schools to reduce the prevalence of self-harm.

Psychiatric disorders among asthmatic patients: Literature review

2016 ◽  
Vol 33 (S1) ◽  
pp. S376-S376
Author(s):  
C.A. Moreira ◽  
A.M. Marinho ◽  
L.C. Gil ◽  
M. Bairrão ◽  
L. Queiroz
Keyword(s):  
General Population ◽  
Panic Disorder ◽  
Psychiatric Disorders ◽  
Public Health Problem ◽  
Close Correlation ◽  
Major Public Health Problem ◽  
Psychological Consequences ◽  
Asthmatic Patients ◽  
Pubmed Database ◽  
Competing Interest

IntroductionAsthma is a major public health problem and its prevalence has increased in both developed and developing countries during the last few years. Once it is a chronic illness, it has also revealed psychological consequences. Moreover, recent studies have suggested an association between asthma (especially of severe grade) and mental disorders.ObjectivesThe authors pretend to make a brief review concerning psychiatric disorders among asthmatic patients.AimsTo understand and to be able to deal with the psychiatric disorders among chronic asthmatic patients.MethodsThe review was based on scientific documentation published in PubMed database, using the following terms as keywords: “asthma”, “depression”, “anxiety” and “panic disorder”.ResultsCompared to the general population, both anxiety and mood disorders rates are at least two times those observed in asthmatic patients. Moreover, certain psychiatric disorders rates, including panic disorder (PD) and major depressive disorder, are as much as six times more prevalent among asthmatics when compared to the general population. The association between psychiatric disorders and poor asthma control and asthma-related quality of life could occur through several pathways, such as behavioural pathways; cognitive or perceptual pathways; or through the direct physiological effects of depression and anxiety on the autonomic nervous system (ANS) and immune systems which increase asthma symptomatology.Discussions/ConclusionsThere is a close correlation between anxiety, PD and depression, and a poor controlled asthma. A better understanding of this association may have major clinical implications, mainly in patients with poor controlled asthma in whom the presence of anxiety and depression should be investigated.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Sociodemographic and clinical profile in elderly suicide victims: 34 autopsy case studies

2017 ◽  
Vol 41 (S1) ◽  
pp. s887-s887
Author(s):  
S. Ellouze ◽  
I. Baati ◽  
W. Ben Amar ◽  
D. Trigui ◽  
W. Abbes ◽  
...  
Keyword(s):  
Public Health ◽  
Health Problem ◽  
Suicide Risk ◽  
Public Health Problem ◽  
The Elderly ◽  
University Hospital ◽  
Major Public Health Problem ◽  
Treatment Of Depression ◽  
Competing Interest ◽  
Elderly Suicide

IntroductionThe elderly suicide is a major public health problem that is gaining more and more ground, given the aging population problem. This has rarely been the subject of forensic studies in Tunisia.ObjectivesTo identify the sociodemographic and clinical characteristics of elderly suicide victims over 60 years and to determine what factors might increase suicide risk in this population.MethodsWe conducted a retrospective study on suicide victims aged 60 and over, autopsied in forensic medicine department of the Habib Bourguiba university hospital in Sfax (Tunisia), on a 10-year period (January 2006–December 2015).ResultsWe identified 34 cases with an average age of 66 years. The sex ratio was 2.77. Suicide victims were alone in 38.2% of cases. They were inactive professionally in 32.4% of cases. Almost half of them (44.1%) had a psychiatric history, 40% of depressed pace, 26.7% of bipolar disorder and 13.3% of schizophrenia.Three main factors were identified as precipitating the passage to suicidal act: family conflicts (26.5%), financial difficulties (11.8%) and loss of autonomy (5.9%).Suicide methods were hanging (50%), immolation and drug intoxication (11.8%), hit by train and poisoning (8.8%), jumping from height (5.9%) and drowning (2.9%). In 55.8% of cases, suicide took place at home.ConclusionElderly suicide seems to be a huge but largely preventable public health problem. Its prevention is essentially based on the identification of risk situations and the detection and treatment of depression: major suicide risk factor in this population.Disclosure of interestThe authors have not supplied their declaration of competing interest.

scholarly journals The effect of therapeutic phlebotomy for hemochromatosis on non-suicidal self-injury: A case report

2018 ◽  
Vol 54 (1) ◽  
pp. 74-79
Author(s):  
Benjamin JC Newham ◽  
Rahul Khanna
Keyword(s):  
Risk Assessment ◽  
Case Report ◽  
Adverse Outcomes ◽  
Case Presentation ◽  
First Report ◽  
Self Injury ◽  
Assessment And Monitoring ◽  
Self Harm ◽  
The Relationship

Background Self-phlebotomy has been described as a form of non-suicidal self-injury. However, a relationship between non-suicidal self-injury and therapeutic phlebotomy for hemochromatosis has not previously been described. Case presentation: We present a case of a 52-year-old man in whom the frequency of his therapeutic phlebotomy and non-suicidal self-injury were inversely linked, leading to adverse outcomes when his phlebotomy was suspended. Conclusions This is the first report describing the relationship between non-suicidal self-injury and therapeutic phlebotomy. This case highlights the need for risk assessment and monitoring of self-harm in patients who are undergoing therapeutic phlebotomy in order to prevent adverse outcomes.

Quetiapine XR reduce impulsivity and dissociation in a sample of alcoholic patients

2016 ◽  
Vol 33 (S1) ◽  
pp. S312-S313
Author(s):  
M. Godio ◽  
M. Preve ◽  
N.E. Suardi ◽  
E. Bolla ◽  
R.A. Colombo ◽  
...  
Keyword(s):  
Public Health Problem ◽  
Future Research ◽  
Final Visit ◽  
Major Public Health Problem ◽  
Research Directions ◽  
Quetiapine Xr ◽  
Oral Naltrexone ◽  
Affective Temperament ◽  
Future Research Directions ◽  
Competing Interest

IntroductionAlcohol dependence (AD) is a major public health problem. Currently, three drugs for the treatment of AD have been approved: acamprosate, disulfiram and oral naltrexone. Quetiapine XR is an atypical antipsychotic has been shown to be a promising medication for the treatment of alcoholism [1,2]. The aim of our study is evaluate quetiapine efficacy on impulsivity in a sample of alcoholic patients.MethodA sample of alcoholic patients (n = 40) was assessed at the entrance and 2 months with: SCID-P, Brief-Temps, BIS-11, GSR, BPRS, SCI-DER, and CGI. The medium dosage of quetiapine is 300 mg.ResultsUsing the last observation carried forward, the mean total BIS score decreased from 60.8 at baseline to 40.2 at the final visit (P = .03). More pronounced improvement was observed in motor impulsiveness (P < .03) and attentional impulsiveness (P < .05) compared with non-planning impulsiveness (P = .09). We observed an improvement in SCI-DER total score (P = .02), in particular in derealization (P = .03) and autopsychic depersonalization (P = .04). A mean weight gain of 4.8 kg was observed. There is not significant different related to the different affective temperament.Discussion and conclusionAnalyses revealed a significant effect of Quetiapine XR in improving impulsivity and dissociation, in particular motor and attentional impulsiveness, derealization and autopsychic depersonalization. Moreover, an improvement of dissociative symptoms is probably connected with the blockade of postsynaptic 5-HT1A receptors [3]. Methodological limitations, clinical implications and suggestions for future research directions are considered.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Evaluation of Dependence Among Benzodiazepines in Population of Elderly Subjects Followed in Psychiatric Service in Sfax

2017 ◽  
Vol 41 (S1) ◽  
pp. S660-S660
Author(s):  
N. Messedi ◽  
I. Feki ◽  
I. Baati ◽  
R. Sellami ◽  
D. Trigui ◽  
...  
Keyword(s):  
Psychotropic Drugs ◽  
Psychiatric Service ◽  
Public Health Problem ◽  
The Elderly ◽  
Cross Sectional Study ◽  
Elderly Subjects ◽  
Major Public Health Problem ◽  
Cross Sectional ◽  
Competing Interest ◽  
Withdrawal Signs

IntroductionBenzodiazepines (BZD) are the most consumed psychotropic drugs by the elders. This prescription can lead to the dependence which is a major public health problem particularly in this population.ObjectivesTo study the prevalence of dependence of the (BZD) in elderly subjects followed as outpatients and to identify the factors associated with it.MethodsIt was a cross-sectional study of 60 patients aged 65 years and older followed at the psychiatric consultation of the UH Hédi Chaker of Sfax; for 3 months. We used:– Questionnaire containing demographic and clinical data.– The cognitive scale of attachment to benzodiazepines (ECAB), a score ≥ 6 indicates dependence.ResultsThe average age of patients was 67.78 years, with a sex-ratio M/W = 0.46. They were smoking in 58.3% of cases. The most frequent psychiatric disorders were mood disorders (40%) followed by anxiety disorders (13.3%). The absence of diagnosis was observed in 23.3% of cases. A psychotropic drugs were associated with BZD in 86.7%. The most prescripted BZD was lorazépam (90%). Withdrawal signs were present in 90% of cases. The prevalence of BZD dependence has been estimated at 80%.BZD dependence was significantly correlated with smoking (P = 0.00), with psychotropics association (P = 0.04) and with signs of withdrawal (P = 0.001).ConclusionIt appears from our study the importance of BZD dependence in the elderly what it is a source of withdrawal difficulty. So we need make more effort to comply with recommendations regarding the prescription of these molecules.Disclosure of interestThe authors have not supplied their declaration of competing interest.

scholarly journals Penicillinase plasmid Australia type in Neisseria gonorrhoeae isolated in Poland

2022 ◽  
Vol 204 (2) ◽  
Author(s):  
Szymon Walter de Walthoffen
Keyword(s):  
Neisseria Gonorrhoeae ◽  
Public Health Problem ◽  
Major Public Health Problem ◽  
Beta Lactamase ◽  
Beta Lactam ◽  
Gene Encoding ◽  
Beta Lactamases ◽  
Lactamase Gene ◽  
Chromosomal Mutations ◽  
First Time

Abstract Purpose Neisseria gonorrhoeae is an etiological agent of gonorrhea which remains a major public health problem the mechanisms that determine resistance to drugs of the beta-lactam class, which are recommended for the treatment of gonorrhea, are currently the most important problem in its treatment. Chromosomal mutations are responsible for resistance to ceftriaxone and cefepime. The possibility of mutations in the gene encoding beta-lactamase (blaTEM) in the penicillinase plasmid may also turn out to be a serious threat. Methods The occurrence of resistance encoded on penicillinase plasmid has been investigated. For this purpose, the susceptibility of bacteria was determined and the gene for resistance to beta-lactams as well as the plasmids themselves was typed. Results Of the 333 strains tested, 21 (6.3%) had the beta-lactamase gene and produced penicillinase. Two of the beta-lactamase: TEM-1 and TEM-135 occurred among the tested strains of N. gonorrhoeae. Most of the known penicillinase plasmid types of N. gonorrhoeae were demonstrated: the Asian, the African, the Toronto/Rio plasmids and Australian variants. Conclusions In the first 3 years, TEM-1 beta-lactamases dominated in N. gonorrhoeae, which were replaced by TEM-135 in the following years of the study. Not all molecular methods are capable of varying the types of penicillinase plasmids. A particularly noteworthy observation is the fact that the Australia-type of penicillinase plasmid (3270 bp) was identified for the first time in Europe, and the second time in the world.

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