Prevalence of mental disorders and deliberate self-harm in Greek male prisoners

2006 ◽  
Vol 29 (1) ◽  
pp. 68-73 ◽  
Author(s):  
M. Fotiadou ◽  
M. Livaditis ◽  
I. Manou ◽  
E. Kaniotou ◽  
K. Xenitidis
2017 ◽  
Vol 44 ◽  
pp. 153-160 ◽  
Author(s):  
N. Verdolini ◽  
A. Murru ◽  
L. Attademo ◽  
R. Garinella ◽  
I. Pacchiarotti ◽  
...  

AbstractBackground:Deliberate self-harm (DSH) causes important concern in prison inmates as it worsens morbidity and increases the risk for suicide. The aim of the present study is to investigate the prevalence and correlates of DSH in a large sample of male prisoners.Methods:A cross-sectional study evaluated male prisoners aged 18+ years. Current and lifetime psychiatric diagnoses were assessed with the Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders - DSM-IV Axis I and Axis II Disorders and with the Addiction Severity Index-Expanded Version. DSH was assessed with The Deliberate Self-Harm Inventory. Multivariable logistic regression models were used to identify independent correlates of lifetime DSH.Results:Ninety-three of 526 inmates (17.7%) reported at least 1 lifetime DSH behavior, and 58/93 (62.4%) of those reported a DSH act while in prison. After multivariable adjustment (sensitivity 41.9%, specificity 96.1%, area under the curve = 0.854, 95% confidence interval CI = 0.811–0.897, P < 0.001), DSH was significantly associated with lifetime psychotic disorders (adjusted Odds Ratio aOR = 6.227, 95% CI = 2.183–17.762, P = 0.001), borderline personality disorder (aOR = 6.004, 95% CI = 3.305–10.907, P < 0.001), affective disorders (aOR = 2.856, 95% CI = 1.350–6.039, P = 0.006) and misuse of multiple substances (aOR = 2.024, 95% CI = 1.111–3.687, P = 0.021).Conclusions:Borderline personality disorder and misuse of multiple substances are established risk factors of DSH, but psychotic and affective disorders were also associated with DSH in male prison inmates. This points to possible DSH-related clinical sub-groups, that bear specific treatment needs.


1999 ◽  
Vol 29 (5) ◽  
pp. 1141-1149 ◽  
Author(s):  
J. T. O. CAVANAGH ◽  
D. G. C. OWENS ◽  
E. C. JOHNSTONE

Background. Mental disorders are major risk factors for suicide. Not all those who suffer from mental disorders kill themselves. Additional information is required to differentiate higher and lesser risk patients.Methods. Retrospective case–control comparison was made of cases of suicide/undetermined death with living controls using psychological autopsy in South East Scotland. Cases and controls were matched for age, sex and mental disorder. Informants were those closest to cases and controls. The subjects were 45 cases of suicide/undetermined death and 40 living controls.Results. Cases and controls did not differ significantly in severity of mental disorder. The main factors independently associated with undetermined death or suicide were: a history of deliberate self-harm (adjusted OR 4·1); physical ill health (adjusted OR 7·8); and engagement by mental health services (adjusted OR 0·01). Other antecedents associated with increased risk (criminal record, police involvement, financial problems and failure to vote) and those associated with decreased risk (contact with a doctor and in-patient care) did not exert effects after controlling for confounding.Conclusions. Controls were receiving more care of whatever kind. Treatment of mental disorder co-morbid with physical illness and a history of deliberate self-harm may be especially important. Factors that separate those with mental disorder at high risk from those at lesser risk relate to care levels provided, which may be a function of engagement by and with health services. The role of mental health professionals is beneficial in suicide prevention. The focusing of that role towards engaging alienated or ‘difficult’ patients should be addressed.


2003 ◽  
Vol 11 (2) ◽  
pp. 150-155 ◽  
Author(s):  
Philip Boyce ◽  
Greg Carter ◽  
Jonine Penrose-Wall ◽  
Kay Wilhelm ◽  
Robert Goldney

Objective: To provide a summary of the Royal Australian and New Zealand College of Psychiatrists (RANZCP) Clinical Practice Guideline for the Management of Deliberate Self-Harm. Conclusions: This guideline covers self-harm regardless of intent. It is an evidence-based guideline developed from a systematic review of epidemiological, treatment and medico-legal literature. All patients presenting to hospital after deliberate self-harm should be comprehensively assessed to detect and treat the high rates of mental disorders, alcohol and other drug problems and personality disorders in this group. General hospital management aims to ensure safety from further self-harm, assess and treat injuries; prevent disablement and death as a result of injuries or poisoning and manage suicide risk by ensuring prompt psychiatric referral and mobilizing social supports. Psychological management aims to detect and treat underlying mental disorders, reduce distress and enhance coping skills and thereby, reduce repeat episodes and habituation of self-harm. Managing suicide risk is a continuous responsibility and suicide vulnerability may persist long-term in some patients. There is little firm guidance from the literature on treatment efficacy to guide ongoing psychiatric management. Studies are often compromised because between 41 and 70% of patients do not attend follow up. The mainstay of psychological care remains the treatment of underlying Axis I and Axis II disorders. Cognitive-behavioural therapy (CBT) and problem-orientated approaches appear promising for reducing repeated self-harm for most patient groups but no single treatment has confirmed superiority. Dialectical behaviour therapy (DBT) appears to confer most benefit. Self-harm may follow some forms of in-depth therapy in some vulnerable individuals. There is no one recommended pharmacological treatment specifically to reduce self-harming behaviours. Lithium may have antiself-harm properties for some groups with bipolar disorder. There is emerging evidence for selfharm reduction using clozapine for patients with schizophrenia and schizoaffective disorder.


Crisis ◽  
2011 ◽  
Vol 32 (5) ◽  
pp. 272-279 ◽  
Author(s):  
Allison S. Christian ◽  
Kristen M. McCabe

Background: Deliberate self-harm (DSH) occurs with high frequency among clinical and nonclinical youth populations. Although depression has been consistently linked with the behavior, not all depressed individuals engage in DSH. Aims: The current study examined maladaptive coping strategies (i.e., self-blame, distancing, and self-isolation) as mediators between depression and DSH among undergraduate students. Methods: 202 students from undergraduate psychology courses at a private university in Southern California (77.7% women) completed anonymous self-report measures. Results: A hierarchical regression model found no differences in DSH history across demographic variables. Among coping variables, self-isolation alone was significantly related to DSH. A full meditational model was supported: Depressive symptoms were significantly related to DSH, but adding self-isolation to the model rendered the relationship nonsignificant. Limitations: The cross-sectional study design prevents determination of whether a casual relation exists between self-isolation and DSH, and obscures the direction of that relationship. Conclusions: Results suggest targeting self-isolation as a means of DSH prevention and intervention among nonclinical, youth populations.


Crisis ◽  
2005 ◽  
Vol 26 (1) ◽  
pp. 4-11 ◽  
Author(s):  
E. Kinyanda ◽  
H. Hjelmeland ◽  
S. Musisi

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.


Crisis ◽  
2019 ◽  
Vol 40 (6) ◽  
pp. 422-428 ◽  
Author(s):  
Chris Rouen ◽  
Alan R. Clough ◽  
Caryn West

Abstract. Background: Indigenous Australians experience a suicide rate over twice that of the general population. With nonfatal deliberate self-harm (DSH) being the single most important risk factor for suicide, characterizing the incidence and repetition of DSH in this population is essential. Aims: To investigate the incidence and repetition of DSH in three remote Indigenous communities in Far North Queensland, Australia. Method: DSH presentation data at a primary health-care center in each community were analyzed over a 6-year period from January 1, 2006 to December 31, 2011. Results: A DSH presentation rate of 1,638 per 100,000 population was found within the communities. Rates were higher in age groups 15–24 and 25–34, varied between communities, and were not significantly different between genders; 60% of DSH repetitions occurred within 6 months of an earlier episode. Of the 227 DSH presentations, 32% involved hanging. Limitations: This study was based on a subset of a larger dataset not specifically designed for DSH data collection and assesses the subset of the communities that presented to the primary health-care centers. Conclusion: A dedicated DSH monitoring study is required to provide a better understanding of DSH in these communities and to inform early intervention strategies.


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