A Comparison of Self-Harm Presentations to Emergency Services

Crisis ◽  
2020 ◽  
Vol 41 (5) ◽  
pp. 389-397
Author(s):  
Hayley Chartrand ◽  
Bruce Tefft ◽  
Jitender Sareen ◽  
Diane Hiebert-Murphy ◽  
Laurence Y. Katz ◽  
...  
Keyword(s):  
Emergency Services ◽  
Suicide Attempts ◽  
Tertiary Care ◽  
Previous History ◽  
Adjustment Disorder ◽  
Cross Sectional ◽  
Need For Treatment ◽  
History Of ◽  
Self Harm ◽  
Cross Sectional Design

Abstract. Background: In the Diagnostic and Statistical Manual of Mental Disorders, 5th Edition, the distinction between nonsuicidal self-injury (NSSI) and suicide attempts (SA) is highlighted in the section of conditions for further study. Aims: The objective of this study was to examine the correlates of people who presented to emergency departments (ED) with NSSI compared with those who presented with SA and no self-harm or suicidal ideation (no SH or SI). Method: Data came from 4,772 presentations to ED of tertiary care hospitals in Manitoba, Canada, between January 2009 and June 2012. Chart reviews were conducted for presentations with NSSI ( n = 158), and a sample of SA ( n = 172) and no SH or SI ( n = 173). Results: NSSI was associated with borderline personality traits/disorders, previous history of SH, and aggression/impulsivity compared with no SH or SI. SA was associated with a lower likelihood of adjustment disorder ( OR = 0.58; 95 % CI [0.34, 0.99]) and previous history of NSSI ( OR = 0.30; 95 % CI [0.17, 0.53]) compared with NSSI. Limitations: A limitation of this study is its cross-sectional design. Conclusion: Given the distress associated with NSSI, the findings highlight the need for treatment plans that address all those who present to ED with SH regardless of intent.

Psychological, Structural, Social and Economic Determinants of Suicide Attempt: Risk Assessment and Decision Making Strategies

2021 ◽  
pp. 003022282110034
Author(s):  
Azam Farmani ◽  
Mojtaba Rahimianbougar ◽  
Yousef Mohammadi ◽  
Hossein Faramarzi ◽  
Siamak Khodarahimi ◽  
...  
Keyword(s):  
Risk Assessment ◽  
Suicide Attempt ◽  
Suicide Attempts ◽  
Psychological Services ◽  
Cross Sectional ◽  
Economic Determinants ◽  
History Of ◽  
Cross Sectional Design ◽  
High Level ◽  
Risk Assessment And Management

The aim of this research was to conduct a risk assessment and management of psychological, structural, social and economic determinants (PSSED) in a suicide attempt. The sample consisted of 353 individuals who had a recorded history of suicidal attempt; and 20 professional individuals by purposive sampling method within a descriptive cross-sectional design. Worksheets for RAM and AHP were used for data collection in this study. The rate of suicide attempt was 7.21 per 100,000 population in this study. Analysis showed that depression and mental disorders; personality disorders; family problems; socio-cultural and economic problems; lack of awareness; and low level of education have a high level of risk for suicide attempts. Psychiatric and psychological services; awareness and knowledge of life skills; medical services to dysfunctional families; development of community-based planning for PSSED of suicide; and employment and entrepreneurship services may lower suicide attempt risk.

scholarly journals Preoperative Anxiety and Fear of Anesthesia in Patients admitted in Tertiary Care Hospitals of Rawalpindi

2020 ◽  
Vol 24 (1) ◽  
pp. 52-58
Author(s):  
Zahra Mariyam ◽  
Laibah Safdar ◽  
Shafaq Fatima ◽  
Jawad Zaheer
Keyword(s):  
Formal Education ◽  
Tertiary Care ◽  
Previous History ◽  
Female Gender ◽  
Preoperative Anxiety ◽  
Cross Sectional ◽  
Significant Difference ◽  
History Of ◽  
History Of Anesthesia ◽  
The Mean

Background: Preoperative apprehension is a widespread global problem. This anxiety and apprehension can significantly affect all aspects of anesthesia and surgery. Thus, it is essential to detect and address the patient's anxiety to assist in recovery after surgery and improve the patient's outcome. Materials and Methods: This is a cross-sectional study conducted over one year in the allied hospitals of Rawalpindi Medical University (RMU). Our sample size was 380 preoperative patients, who were selected by convenience sampling. The Amsterdam Preoperative Anxiety and Information Scale (APAIS) was used.Results: The overall prevalence of anxiety was 30.5%, while the prevalence of information requirement was 33.2%. The mean total APAIS was 12.73±8.56, the mean anxiety subscore was 8.25±5.58, and the mean need for information subscore was 4.48±3.16. A statistically significant difference was found in the scores of the patients based on age, gender, education, type of anesthesia, and type of surgery (p< 0.05). The previous history of anesthesia and the presence of comorbidities did not bring a significant difference in the scores of the patients (p>0.05). Postoperative pain was the most important concern, found in 32% of the patients. Conclusion: Younger age group, female gender, having no formal education, surgery under regional anesthesia, and undergoing C-section, IOL implantation and septoplasty are associated with higher preoperative anxiety, while the presence of comorbidities and previous history of anesthesia are factors that do not significantly affect preoperative anxiety in our population.

scholarly journals Obstetric and neonatal outcome in women with a history of recurrent miscarriage at tertiary care hospital, Karnataka: a retrospective cross-sectional study

2018 ◽  
Vol 7 (2) ◽  
pp. 648 ◽  
Author(s):  
Chintan Upadhyay ◽  
Nisha Upadhyay
Keyword(s):  
Pregnancy Loss ◽  
Recurrent Miscarriage ◽  
Tertiary Care ◽  
Previous History ◽  
Cross Sectional Study ◽  
Care Hospital ◽  
Sectional Study ◽  
Cross Sectional ◽  
Increased Risk ◽  
History Of

Background: When clinical pregnancy is established, the risk of spontaneous pregnancy loss is ~12-14%, and therefore the incidence of Recurrent Pregnancy Loss (RPL) by chance alone would be in the order of 0.35%. It occurs in 0.5-3% of women. The objective of this study was to evaluate the obstetric outcome in pregnancies with history of one or more abortions.Methods: It is a retrospective cross-sectional study done at Obstetrics and Gynecology Department, Dr. B. R. Ambedkar Medical College and Hospital, Bangalore. Record review of cases was done from January 2005 to December 2009. Inclusion criteria were pregnancies with history of previous abortions.Results: There were 400 cases with previous history of abortions. There were 266 (66.4%) booked cases while 134 (33.5%) were unbooked cases. 272 (68.0%) patients crossed viable period of pregnancy (more than 28 weeks). Around 56 (14.0%) cases had repeat abortions, 276 (69.0%) cases underwent vaginal delivery and 124 (31.0%) underwent cesarean section. Almost 91 (22.8%) of Babies were low birth weight while others were above 2.5 kg. There were 52 (13.0%) preterm babies and 28 (7.0%) Intrauterine demise of fetuses.Conclusions: Patients with previous history of abortions are at increased risk of adverse maternal and perinatal outcome.

scholarly journals Suicidal Ideations in Patients With Obsessive-Compulsive Disorder

2022 ◽  
Vol 8 (1) ◽  
pp. 39-48
Author(s):  
Mohammadrasoul Khalkhali ◽  
◽  
Roghaye Zare ◽  
Hassan Farrahi ◽  
Peyvand Shambayati ◽  
...  
Keyword(s):  
Suicidal Ideation ◽  
Obsessive Compulsive Disorder ◽  
Rating Scale ◽  
Suicide Attempts ◽  
Previous History ◽  
Obsessive Compulsive ◽  
Cross Sectional ◽  
Compulsive Disorder ◽  
First Degree Relatives ◽  
History Of

Background: There are many controversies about the frequency and burden of suicidality in patients with Obsessive-Compulsive Disorder (OCD). Objectives: This study was done to determine the prevalence and risk factors of current suicidal ideations in patients with OCD. Materials & Methods: In this cross-sectional study, 258 outpatients with OCD (Yale-Brawn Obsessive Compulsive Scale, Y-BOCS ≥16) referring to two psychiatry clinics in Guilan, Iran, from March 2018 to September 2019 were evaluated. Suicidality score of the Brief Psychiatric Rating Scale (BPRS) ≥4 was considered for current suicidal ideation at the first visit. Beck Scale for Suicidal Ideation (BSSI) was used to evaluate the intensity of suicidal ideations a week before evaluation. Simple linear and binary logistic regression analyses were used to analyze data by SPSS v. 20. Results: Current suicidal ideation was found in 22.1% of patients. The previous history of suicide attempt (BPRS, P<0.0001 and BSSI, P<0.0001), a history of OCD in first-degree relatives (BPRS: P=0.004 and BSSI: P=0.010), a history of suicide attempts in first-degree relatives (BPRS: P=0.013 and BSSI: P<0.0001), comorbid diagnosis of depressive or body dysmorphic disorder (BPRS, P<0.0001 and BSSI, P<0.0001), and higher Y-BOCS score (BPRS: P=0.043 and BSSI: P<0.0001) were associated with a higher risk of having suicidal ideation. Conclusion: Suicidal thoughts are high in Iranian patients with OCD at their first visit to psychiatry clinics. The previous suicide history, positive history of OCD and suicide attempts in their first-degree relatives, the severity of OCD, and some comorbid psychological disorders are associated with a higher risk of suicidal ideation among OCD patients.

Prevalence and Clinical Features Associated with Unrecognized Bipolar Disorder among Outpatients with Depressive Disorder in Thailand

2021 ◽  
Vol 104 (11) ◽  
pp. 1821-1827
Keyword(s):  
Bipolar Disorder ◽  
Depressive Disorder ◽  
Clinical Features ◽  
Suicide Attempts ◽  
Bipolar Depression ◽  
University Hospital ◽  
Cross Sectional ◽  
Atypical Depression ◽  
History Of ◽  
Self Harm

Objective: To determine the prevalence of unrecognized bipolar disorder and explore the clinical features of outpatients with depressive disorder associated with bipolar disorder. Materials and Methods: The present study was a cross-sectional study. One hundred six volunteer participants, diagnosed with depressive disorder at Naresuan University Hospital, Buddhachinaraj Phitsanulok Hospital, and Phichit Hospital participated in this study. Psychiatrists interviewed the participants to collect basic data and clinical characteristics to determine unrecognized bipolar disorder using the Thai version of the Mini International Neuropsychiatric Interview (MINI). Results: The results showed that the prevalence of unrecognized bipolar disorder was 18.9%. When multivariable logistic regression was used, it was found that there were two statistically significant factors associated with unrecognized bipolar disorder. These factors were a history of self-harm or suicide attempts (AOR 4.40, 95% CI 1.24 to 15.60), and atypical depression seen with overeating and hypersomnia (AOR 11.73, 95% CI 2.32 to 59.35). Conclusion: There are several misdiagnoses of patients with bipolar disorder because the patients are usually in a depressive state when they decide to consult a doctor. Therefore, doctors should further probe especially in patients with atypical depression, history of self-harm or attempted suicide. Keywords: Bipolar depression; Bipolar disorder; Diagnosis; Epidemiology; Prevalence

scholarly journals From Emotional Intelligence to Self-Injuries: A Path Analysis in Adolescents With Conduct Disorder

2021 ◽  
Vol 11 ◽  
Author(s):  
Joanna Halicka-Masłowska ◽  
Monika Szewczuk-Bogusławska ◽  
Joanna Rymaszewska ◽  
Agnieszka Adamska ◽  
Błażej Misiak
Keyword(s):  
Emotional Intelligence ◽  
Conduct Disorder ◽  
Test Validity ◽  
Self Esteem ◽  
Conduct Disorders ◽  
Cross Sectional ◽  
Trait And State Anxiety ◽  
History Of ◽  
Self Harm ◽  
Cross Sectional Design

Objective: Self-harm acts are highly prevalent among adolescents with conduct disorder. It has been shown that low level of emotional intelligence (EI) might be related to a higher risk of self-injuries. However, the exact mechanisms underlying this association are still unclear. The purpose of this study was to explore whether psychopathological symptoms and selected psychological processes mediate the association between EI and self-harm risk in adolescents with conduct disorders.Method: Out of 162 adolescents with conduct disorder approached for participation, 136 individuals (aged 14.8 ± 1.2 years, 56.6% females) were enrolled and completed the questionnaires evaluating the level of EI, depression, anxiety, impulsiveness, empathy, venturesomeness, self-esteem, and disgust.Results: Individuals with a lifetime history of self-injuries had significantly higher levels of depression, anxiety and impulsivity as well as significantly lower levels of EI and self-esteem. Higher levels of EI were associated with significantly higher levels of self-esteem, venturesomeness and empathy as well as significantly lower levels of depression, anxiety and impulsivity. Further analysis revealed that trait and state anxiety as well as self-esteem were complete mediators of the association between EI and self-harm risk.Conclusions: Our findings indicate that anxiety and self-esteem might mediate the association between EI and a risk of self-injuries in adolescents with conduct disorder. However, a cross-sectional design of this study limits conclusions on the direction of causality. Longitudinal studies are needed to test validity of our model.

Perceived Stress and Intent to Die in Young Soldiers Who Attempt Suicide

Crisis ◽  
2018 ◽  
Vol 39 (2) ◽  
pp. 144-148 ◽  
Author(s):  
Leah Shelef ◽  
Anat Brunstein Klomek ◽  
Nirit Yavnai ◽  
Golan Shahar
Keyword(s):  
Young Adult ◽  
Perceived Stress ◽  
Military Service ◽  
Suicide Ideation ◽  
Suicide Attempts ◽  
Self Report ◽  
Cross Sectional ◽  
Israeli Defense Force ◽  
History Of ◽  
Cross Sectional Design

Abstract. Background: Intent to die is an important component of suicide risk assessment. The authors compared the predictive effect of two forms of stress – military and perceived – in intent to die by suicide among young adult Israeli soldiers with a history of suicide attempts. Depression, suicide ideation, and habituation/acquired capacity for suicidality served as covariates. Methods: Participants were 60 young adult soldiers in the Israeli Defense Force (ISF; aged 18–21 years), who made a suicide attempt during their military service. Study variables were assessed using self-report measures. Results: Intent to die by suicide correlated with suicide ideation, habituation/acquired capacity, depressive symptoms, and perceived stress. In a multiple regression analysis, perceived stress predicted intent to die (b = .44, p = .002) over and above the prediction by suicide ideation (b = .42, p = .013) and acquired capacity/habituation (b = .28, p = .023). Limitations: The cross-sectional design restricts causal inference. In addition, an exclusive reliance on self-report measures might have inflated shared method variance. Conclusions: Perceived stress captures a unique dimension of intent to die by suicide among young suicide attempters.

Depressed Multiple-Suicide­Attempters – A High-Risk Phenotype

Crisis ◽  
2017 ◽  
Vol 38 (6) ◽  
pp. 367-375 ◽  
Author(s):  
Leo Sher ◽  
Michael F. Grunebaum ◽  
Ainsley K. Burke ◽  
Sadia Chaudhury ◽  
J. John Mann ◽  
...  
Keyword(s):  
Family History ◽  
Suicide Attempt ◽  
Suicide Attempts ◽  
Borderline Personality ◽  
Cross Sectional ◽  
Suicide Attempters ◽  
Depressed Patients ◽  
Suicide Intent ◽  
History Of ◽  
Cross Sectional Design

Abstract. Background: There is compelling evidence that suicide attempts are among the strongest predictors of suicide and future suicide attempts. Aim: This study aimed to examine psychopathology in multiple-suicide attempters. Method: We compared the demographic and clinical features of three groups: depressed patients without a history of suicide attempts (non-attempters), depressed patients with a history of one to three suicide attempts (attempters), and depressed patients with a history of four or more suicide attempts (multiple attempters). Results: We found that attempters and multiple attempters had higher levels of depression, hopelessness, aggression, hostility, and impulsivity and were more likely to have borderline personality disorder and family history of major depression or alcohol use disorder compared with non-attempters, but did not differ between each other on these measures. Multiple attempters had greater suicidal ideation at study entry and were more likely to have family history of suicide attempt compared with attempters. Importantly, multiple attempters had greater suicide intent at the time of the most medically serious suicide attempt and more serious medical consequences during their most medically serious suicide attempt compared with attempters. Limitations: The cross-sectional design of the study. Conclusion: Our data suggest that multiple-suicide attempters require careful evaluation as their behavior can have serious medical consequences.

scholarly journals Lessons Learnt From the Narratives of Women Who Self-Harm in Prison

Crisis ◽  
2020 ◽  
pp. 1-8
Author(s):  
Tammi Walker ◽  
Jenny Shaw ◽  
Jonathan Gibb ◽  
Clive Turpin ◽  
Catherine Reid ◽  
...  
Keyword(s):  
Sexual Abuse ◽  
Community Settings ◽  
Cross Sectional ◽  
History Of ◽  
Women In Prison ◽  
Self Harm ◽  
Cross Sectional Design ◽  
Reported Data ◽  
Past Experiences ◽  
Structured Questionnaire

Abstract. Background: In England and Wales, women in prison make up a minority (<5%) of the total custodial population, yet acts of self-harm are around five times more common among incarcerated women. While there has been a multiagency effort to improve how acts of self-harm are documented across prisons, the patterns and functions of self-harm for women in prison have not yet been fully addressed. Aims: We aimed to determine the patterns, prevalence, and functions of self-harm among women in prison through a mixed-methods study. Method: A total of 108 women with a history of self-harm were interviewed across three female prisons. Participants completed a structured questionnaire detailing their experiences of self-harm across prison and community settings. Results: We found that women in prison who frequently self-harmed disclosed high levels of trauma: past experiences of domestic violence (81.5%), childhood sexual abuse (66.7%), and adult sexual abuse (60.2%). Prevalent methods of recent in-prison acts of self-harm involved cutting, followed by ligaturing. Limitations: The study used a cross-sectional design, self-reported data, and featured a subset of women identified as being at high-risk of self-harm. Conclusion: Motivations behind acts of self-harm by women in prison are complex. Triggers appear to be past trauma, deteriorating mental health, and separation from children or family.

scholarly journals DISTRIBUTION OF DELIBERATE SELF-POISONING BY SOCIO-DEMOGRAPHIC FACTORS, PRECIPITATING EVENTS, TYPE OF SUBSTANCE AND MORTALITY IN POPULATION OF HAZARA DIVISION, PAKISTAN

2020 ◽  
Vol 18 (2) ◽  
pp. 68-74
Author(s):  
Adnan Khan ◽  
Abdul Rauf ◽  
Saqib Malik ◽  
Imran Ullah ◽  
Abdul Majid Khan ◽  
...  
Keyword(s):  
Previous History ◽  
Demographic Factors ◽  
Common Type ◽  
Age Group ◽  
Cross Sectional ◽  
Joint Family ◽  
Lower Socioeconomic ◽  
History Of ◽  
Self Harm ◽  
Socio Demographic Factors

Background: Deliberate self-poisoning is important cause of deaths in younger population. The objectives of this study were to determine the distribution of deliberate self-poisoning by 12 socio-demographic factors, precipitating events, type of substance and mortality in population of Hazara Division, Pakistan. Materials & Methods: This cross-sectional study was conducted in the Department of Medicine, Ayub Medical College, Abbottabad, Pakistan from October 9, 2017 to December 28, 2018. 102 deliberate self-poisoning patients were selected consecutively from population at risk. Variables were 12 socio-demographic factors, precipitating events, type of substance and mortality. All variables being categorical were described by count and percentage for sample and by confidence intervals for proportion for population at 95% confidence level. RESULTS: Deliberate self-poisoning cases (n=102) were higher in women 80.39%, in age group 18-25 years 54.90%, similar in urban 49.02% and rural 50.98%, higher in non-Pathan 74.51%, in married 57.84%, in joint family 79.41%, in up to matric education 85.29% and in housewives 52.94%, 4.90% with previous history of self-harm, 1.96% with family history of self-harm and higher in lower socioeconomic group 81.37%. The most common precipitating event was interpersonal difficulties with spouse, family members or friends 56.86%, while the most common type of substance was organophosphate 62.75%. Mortality was 3.92%. Conclusion: Deliberate self-poisoning was more prevalent in women, younger age group, married, joint family, educated up to matric, housewives and lower socioeconomic status. Family conflict was most common precipitating factor. Organophosphate was most common type of substance and mortality was high 3.92%.

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