Psychosocial therapy and causes of death after deliberate self-harm: a register-based, nationwide multicentre study using propensity score matching

2016 ◽  
Vol 46 (16) ◽  
pp. 3419-3427 ◽  
Author(s):  
J. Birkbak ◽  
E. A. Stuart ◽  
B. D. Lind ◽  
P. Qin ◽  
E. Stenager ◽  
...  
Keyword(s):  
Causes Of Death ◽  
Comparison Group ◽  
Therapy Group ◽  
Medical Conditions ◽  
Behavioural Disorders ◽  
Deliberate Self Harm ◽  
Psychosocial Therapy ◽  
Self Harm ◽  
External Causes

BackgroundPsychosocial therapy after deliberate self-harm might be associated with reduced risk of specific causes of death.MethodIn this matched cohort study, we included patients, who after an episode of deliberate self-harm received psychosocial therapy at a Suicide Prevention Clinic in Denmark between 1992 and 2010. We used propensity score matching in a 1:3 ratio to select a comparison group from 59 046 individuals who received standard care. National Danish registers supplied data on specific causes of death over a 20-year follow-up period.ResultsAt the end of follow-up, 391 (6.9%) of 5678 patients in the psychosocial therapy group had died, compared with 1736 (10.2%) of 17 034 patients in the matched comparison group. Lower odds ratios of dying by mental or behavioural disorders [0.54, 95% confidence interval (CI) 0.37–0.79], alcohol-related causes (0.63, 95% CI 0.50–0.80) and other diseases and medical conditions (0.61, 95% CI 0.49–0.77) were noted in the psychosocial therapy group. Also, we found a reduced risk of dying by suicide as well as other external causes, however, not by neoplasms and circulatory system diseases. Numbers needed to treat were 212.9 (95% CI 139.5–448.4) for mental or behavioural disorders as a cause of death, 111.1 (95% CI 79.2–210.5) for alcohol-related causes and 96.8 (95% CI 69.1–161.8) for other diseases and medical conditions.ConclusionsOur findings indicate that psychosocial therapy after deliberate self-harm might reduce long-term risk of death from select medical conditions and external causes. These promising results should be tested in a randomized design.

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.

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

Secondary Prevention of Non-fatal Deliberate Self-harm

1993 ◽  
Vol 163 (1) ◽  
pp. 111-112 ◽  
Author(s):  
H. G. Morgan ◽  
E. M. Jones ◽  
J. H. Owen
Keyword(s):  
British Journal ◽  
Early Stage ◽  
Psychiatric Services ◽  
Easy Access ◽  
Deliberate Self Harm ◽  
Self Harm ◽  
One Year ◽  
First Time ◽  
Experimental Group

In an attempt to address the low compliance with offers of treatment shown by patients after episodes of non-fatal deliberate self-harm (DSH), patients who had harmed themselves for the first time were offered rapid, easy access to on-call trainee psychiatrists in the event of further difficulties, and they were encouraged to seek help at an early stage should such problems arise. The follow-up data obtained after one year showed a significant reduction of actual or seriously threatened DSH in the experimental group, who also made considerably less demands on medical and psychiatric services, when compared with controls.British Journal of Psychiatry (1993), 163, 111–112

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.

The Development of Behavioural Coping Skills in a Repetitive and Deliberately Self-Harming Young Woman

2004 ◽  
Vol 33 (2) ◽  
pp. 237-242 ◽  
Author(s):  
Malcolm Wheatley ◽  
Clive Hollin
Keyword(s):  
Young Woman ◽  
Coping Skills ◽  
Single Case ◽  
Ethical Considerations ◽  
Deliberate Self Harm ◽  
Intervention Phase ◽  
Assessment Period ◽  
Effective Delivery ◽  
Self Harm

This project reports on the effective delivery of a behavioural coping skills programme with a repetitive deliberately self-harming young woman. A simple single case A-B design was employed to evaluate the intervention due to the applied nature of the project and ethical considerations. An assessment period prior to the intervention phase constituted an extended baseline. Data concerning the primary dependent variable, deliberate self-harm, were collected for a 3-month follow-up period.

A comparison of psychiatric and primary care follow-up after emergency department presentations of deliberate self-harm

2018 ◽  
Vol 109 ◽  
pp. 109
Author(s):  
J. Hunter ◽  
R. Maunder ◽  
P. Kurdyak ◽  
A. Wilton ◽  
A. Gruneir ◽  
...  
Keyword(s):  
Primary Care ◽  
Emergency Department ◽  
Deliberate Self Harm ◽  
Self Harm

Suicide in the 18 Years After Deliberate Self-harm

1996 ◽  
Vol 169 (4) ◽  
pp. 489-494 ◽  
Author(s):  
Gregory M. De Moore ◽  
Andrew R. Robertson
Keyword(s):  
Strong Predictor ◽  
Young Male ◽  
Demographic Information ◽  
Specific Data ◽  
Deliberate Self Harm ◽  
Male Suicide ◽  
Completed Suicide ◽  
Self Harm ◽  
Sydney Australia

BackgroundClinical and demographic information on patients seen as a result of deliberate self-harm (DSH) was collected in an attempt to identify factors in the index episode of DSH predictive of subsequent suicide.MethodSpecific data were prospectively collected on all DSH patients who lived in Blacktown Municipality, Sydney, Australia, and seen from October 1975 to September 1976. Follow-up at 18 years was by evaluation of coroners' records and identification of ‘probable suicide’.ResultsTwo hundred and twenty-three patients harmed themselves on one or more occasions. Follow-up at 18 years showed that 15 of the 223 (6.7%) had completed suicide. The proportion at five and eight years was 4.0% and at 10 years was 4.5%. Identified predictors of suicide were: narcotic overdose; more than one episode of DSH in the year of the study; planned episode; and mental illness. Teenage narcotic-abusing males were at greatest risk, and in females a planned episode was the most powerful predictor.ConclusionsSuicides continued to occur over 18 years. One of the striking differences between this and other studies is the finding of teenage male DSH, associated with narcotic abuse, as a strong predictor of subsequent suicide. These findings are particularly relevant to the issue of young male suicide, which increased from the 1970s onwards in Australia and elsewhere.

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