Transactions of Violence, Victimization, Suicide and Self-Harm Behavior among Civil Psychiatric Patients

2013 ◽  
Author(s):  
Ashley Pritchard ◽  
Adam Joseph Evans Blanchard ◽  
Diane S. Strub ◽  
Kevin Douglas ◽  
Tonia Nicholls
Keyword(s):  
Psychiatric Patients ◽  
Violence Victimization ◽  
Self Harm

scholarly journals Informal psychiatric patients requesting discharge

1994 ◽  
Vol 18 (4) ◽  
pp. 209-211
Author(s):  
Robin McGilp ◽  
Brian Kidd ◽  
Cameron Stark ◽  
Tom Henderson
Keyword(s):  
Substance Abuse ◽  
Psychiatric Patients ◽  
Medical Advice ◽  
Psychotic Illness ◽  
Against Medical Advice ◽  
The Past ◽  
History Of ◽  
Self Harm ◽  
Discharge Against Medical Advice ◽  
Retrospective Investigation

A retrospective investigation of case-notes compared 54 incidents of informal psychiatric in-patients being detained in hospital on an emergency basis with 66 incidents of discharge against medical advice (AMA). The characteristics of the two groups were compared. Detained patients were more likely to have been detained previously, to be suffering from a psychotic illness, and to have threats of violence or self-harm mentioned in their case-notes. AMA patients were more likely to have a history of substance abuse but were no more likely than the detained group to have been discharged AMA in the past. The results suggest that psychiatrists in this hospital are using current legislation on detention appropriately.

Psychiatric assessment

2013 ◽  
pp. 33-82
Keyword(s):  
Depressed Mood ◽  
Mental State ◽  
Psychiatric Patients ◽  
Clinical Interview ◽  
Anxiety Symptoms ◽  
Psychiatric Assessment ◽  
Case Summary ◽  
Self Harm ◽  
State Examination

The clinical interview Setting the scene Interviewing psychiatric patients Discussing management History Mental state examination Case summary Observations of appearance and behaviour Speech Abnormal mood Asking about depressed mood Asking about thoughts of self-harm Asking about elevated mood Anxiety symptoms Asking about anxiety symptoms Abnormal perceptions...

The role of dissociation and abuse among adolescents who self-harm

2019 ◽  
Vol 53 (10) ◽  
pp. 989-999 ◽  
Author(s):  
Carlos Hoyos ◽  
Vincent Mancini ◽  
Yulia Furlong ◽  
Nick Medford ◽  
Hugo Critchley ◽  
...  
Keyword(s):  
Childhood Abuse ◽  
Comparison Group ◽  
Psychiatric Patients ◽  
Later Life ◽  
Structured Interviews ◽  
Emergency Presentation ◽  
Self Harm ◽  
And Gender ◽  
Matched Comparison

Objectives: Retrospective recall of dissociative symptoms has been found to mediate the association between childhood abuse and deliberate self-harm (DSH) in later life. To disentangle the effect of recall bias, we tested whether dissociation symptoms ascertained during an acute DSH presentation mediates this link. Method: All participants with DSH were recruited during emergency presentation. Seventy-one individuals aged 11–17 years with overdose (OD) and/or self-injury (SI) participated in semi-structured interviews and psychiatric assessment to measure abuse and dissociation. An age- and gender-matched comparison group of 42 non-psychiatric patients admitted to the same service were also assessed. Results: The DSH groups reported significantly higher levels of abuse and dissociation compared to comparison group. Dissociation significantly mediated the association between abuse and DSH. Of the four dissociation subtypes, ‘depersonalisation’ was the primary mediator. Adolescents with chronic patterns of DSH and the ‘OD + SI’ self-harm type reported more severe dissociation. Conclusion: Exposure to abuse significantly increased the risk of DSH in adolescence. This association was mediated by dissociation. Our findings suggest a possible dose–response relationship between dissociation with DSH chronicity and the ‘OD + SI’ self-harm type, implicating the importance of evaluating dissociation and depersonalisation symptoms as well as abuse exposure in DSH management.

Characteristics of Childhood Sexual Abuse and Adult Psychopathology in Female Psychiatric Patients

1997 ◽  
Vol 31 (2) ◽  
pp. 200-207 ◽  
Author(s):  
Jill Pettigrew ◽  
Joyce Burcham
Keyword(s):  
Sexual Abuse ◽  
Childhood Sexual Abuse ◽  
Age Of Onset ◽  
Psychiatric Patients ◽  
Age At Onset ◽  
Self Mutilation ◽  
Self Harm ◽  
Independent Association ◽  
Severe Psychopathology ◽  
Relationship Of

Objective: The present study investigated the relationship of characteristics of childhood sexual abuse and subsequent psychopathology. Method: Referrals to a female psychiatrist in private practice in an urban working class area provided 73 adult female subjects who reported having been sexually abused in childhood. Data were collected on age at onset, duration, physical invasiveness of the abuse, violence, and the number and relationship of abusers. Results: Having had multiple abusers in childhood was significantly (p < 0.01) associated with every outcome measure of severe psychopathology: an initial Global Assessment Functioning score of 50 or below; both single and repeated incidents of deliberate self-harm; overdose; self-mutilation; and psychiatric hospital admission. Conclusions: Notably, having had multiple abusers was the only characteristic showing a reliable independent association with any of these measures. Subjects who had had multiple abusers were significantly more likely to have an earlier age of onset and longer duration of abuse, and to have experienced violent abuse.

Reasons for Involuntary Commitment in Manitoba and Ontario

1983 ◽  
Vol 28 (5) ◽  
pp. 358-361 ◽  
Author(s):  
R. A. Richert ◽  
A. H. Moyes
Keyword(s):  
Mental Health ◽  
Psychiatric Hospitalization ◽  
Psychiatric Patients ◽  
Civil Commitment ◽  
Involuntary Commitment ◽  
Necessary Condition ◽  
Mental Health Act ◽  
Explicit Reference ◽  
Self Harm

This paper concerns itself with the question of involuntary commitment of psychiatric patients in southwestern Manitoba. The purpose was to survey the reasons given for involuntary psychiatric hospitalization by a group of Manitoba physicians in 1979, and to compare these reasons with those given by their Ontario counterparts, as described in the Page and Yates (1) and Page and Firth (2) studies. Particularly, the aim was to compare the relative emphasis given to dangerousness / self-harm reasons, in view of the fact that Manitoba's Mental Health Act makes no explicit reference to the dangerousness criterion, while Ontario's legislation has increasingly specified this factor as a necessary condition for civil commitment.

scholarly journals A Study to Assess the Suicidal Behaviour among the Psychiatric Patients in a Tertiary Care Teaching Hospital, Guntur

2016 ◽  
Vol 3 (4) ◽  
Author(s):  
Dr Vaddadi. Venkata kiran ◽  
Dr. Neeli Uma Jyothi ◽  
Mounica. Bollu
Keyword(s):  
Substance Use ◽  
Suicide Attempt ◽  
Psychiatric Disorders ◽  
Substance Use Disorders ◽  
Suicidal Behaviour ◽  
Psychiatric Patients ◽  
Tertiary Care ◽  
Wide Range ◽  
Self Harm ◽  
Commit Suicide

Suicide attempt is a deliberate act of self harm with at least some intent of die that does not result in death. Such act has a wide range of medical seriousness. Individuals with psychiatric disorders are far more likely to commit suicide than the others. People who are psychologically disabled are often commit suicide from years of pain, frustration and depression. Spiritually they may perceive themselves as hopelessly damaged and lose all sense of purpose and meaning of life. Suicide is not a diagnosis or a disorder. it is a behaviour. Suicide is a worldwide, national, local and familial problem. 90% of people who kill themselves suffer from a diagnosable and preventable problem such as depression co-occurring mental and substance use disorders are common and potent combination among those who die by suicide.

scholarly journals Self-harm in women with postpartum mental disorders

2019 ◽  
Vol 50 (9) ◽  
pp. 1563-1569 ◽  
Author(s):  
Benedicte Marie Johannsen ◽  
Janne Tidselbak Larsen ◽  
Thomas Munk Laursen ◽  
Karyn Ayre ◽  
Louise M. Howard ◽  
...  
Keyword(s):  
Mental Disorders ◽  
Psychiatric Patients ◽  
Elevated Risk ◽  
Psychiatric Facility ◽  
Vulnerable Group ◽  
Childless Women ◽  
First Child ◽  
Increased Risk ◽  
First Onset ◽  
Self Harm

AbstractBackgroundWomen suffering from first onset postpartum mental disorders (PPMD) have a highly elevated risk of suicide. The current study aimed to: (1) describe the risk of self-harm among women with PPMD and (2) investigate the extent to which self-harm is associated with later suicide.MethodsWe conducted a register-based cohort study linking national Danish registers. This identified women with any recorded first inpatient or outpatient contact to a psychiatric facility within 90 days after giving birth to their first child. The main outcome of interest was defined as the first hospital-registered episode of self-harm. Our cohort consisted of 1 202 292 women representing 24 053 543 person-years at risk.ResultsAmong 1554 women with severe first onset PPMD, 64 had a first-ever hospital record of self-harm. Women with PPMD had a hazard ratio (HR) for self-harm of 6.2 (95% CI 4.9–8.0), compared to mothers without mental disorders; but self-harm risk was lower in PPMD women compared to mothers with non-PPMD [HR: 10.1, (95% CI 9.6–10.5)] and childless women with mental disorders [HR: 9.3 (95% CI 8.9–9.7)]. Women with PPMD and records of self-harm had a significantly greater risk for later suicide compared with all other groups of women in the cohort.ConclusionsWomen with PPMD had a high risk of self-harm, although lower than risks observed in other psychiatric patients. However, PPMD women who had self-harmed constituted a vulnerable group at significantly increased risk of later suicide.

scholarly journals The Wessex Recent In-Patient Suicide Study, 2

2001 ◽  
Vol 178 (6) ◽  
pp. 537-542 ◽  
Author(s):  
Elizabeth A. King ◽  
David S. Baldwin ◽  
Julia M. A. Sinclair ◽  
Michael J. Campbell
Keyword(s):  
Risk Factors ◽  
Care Delivery ◽  
Psychiatric Patients ◽  
Retrospective Case ◽  
Patient Suicide ◽  
Increased Risk ◽  
History Of ◽  
Self Harm ◽  
Low Sensitivity ◽  
Control Study

BackgroundPsychiatric patients have an elevated risk of suicide while in hospital.AimsTo compare social, clinical and health-care delivery factors in in-patient and out-patient suicides and their controls.MethodRetrospective case-control study of 59 in-patients and 106 controls, matched for age, gender, diagnosis and admission date. Odds ratios were calculated using conditional multiple logistic regression.ResultsThere were seven independent increased-risk factors: history of deliberate self-harm, admission under the Mental Health Act, involvement of the police in admission, depressive symptoms, violence towards property, going absent without leave and a significant care professional being on leave. When compared with out-patient suicides, in-patients were more often female and male in-patients had a psychotic illness. Unlike the out-patient suicides, social factors were not found to be significant.ConclusionsThe characteristics of inpatient and out-patient suicides differ. Identified risk factors have relatively low sensitivity and specificity.

The Validity and Utility of Risk Assessment for Inpatient Suicide

2011 ◽  
Vol 19 (6) ◽  
pp. 507-512 ◽  
Author(s):  
Matthew Large ◽  
Christopher Ryan ◽  
Olav Nielssen
Keyword(s):  
Risk Factors ◽  
High Risk ◽  
Risk Model ◽  
Psychiatric Patients ◽  
Meta Analysis ◽  
Low Risk ◽  
Prior History ◽  
Inpatient Suicide ◽  
History Of ◽  
Self Harm

Objective: It is widely assumed that identifying clinical risk factors can allow us to determine which patients are at high risk of suicide while in hospital, and that identifying those patients can help prevent inpatient suicide. We aimed to examine the validity and utility of categorizing psychiatric patients to be at either high or low risk of committing suicide while in hospital. Method: The assumption that high-risk categorizations are valid was examined by comparing factors included in high-risk models derived from individual studies of inpatient suicide with the results of a meta-analysis of factors associated with inpatient suicide. A valid high-risk model was then applied to a hypothetical clinical setting in order to test the assumption that high-risk categorizations are useful. Results: The existing models for assessing whether inpatients are at high risk of suicide all include one or more factors that were not found to be associated with inpatient suicide by meta-analysis and were probably chance associations. Depressed mood and a prior history of self-harm are the only well-established independent risk factors for inpatient suicide. Using these risk factors to classify patients as being at high or low risk would prevent few, if any, suicides, and would come at a considerable cost in terms of more restrictive care of many patients and the reduced level of care available to the remaining patients. Conclusions: Risk categorization of individual patients has no role to play in preventing the suicide of psychiatric inpatients.

A study of suicidal attempts and voluntary self-harm admitted to “Al. Obregia” psychiatry clinical hospital between 2008 and 2010

2011 ◽  
Vol 26 (S2) ◽  
pp. 1627-1627
Author(s):  
M. Manea ◽  
V. Rusanu ◽  
B.E. Patrichi ◽  
A.A. Frunza ◽  
S.M. Bectas ◽  
...  
Keyword(s):  
Suicide Risk ◽  
Psychiatric Patients ◽  
Seasonal Pattern ◽  
Suicide Risk Assessment ◽  
Prevention Strategies ◽  
Number Of Children ◽  
Icd 10 ◽  
Self Harm ◽  
The Relationship ◽  
Risk Assessment And Management

IntroductionIn 2009, 8 Romanians committed suicide every day. Suicide risk assessment and management remains difficult for psychiatrists worldwide and requires further study and a better implementation of prevention strategies.AimsTo identify the relationship between demographic and clinical data in a sample of psychiatric patients admitted after a suicideattempt and voluntary self-harm (VSH-SA) to our hospital between 2008 and 2010.ObjectivesThe purpose of this study is to determine which factors, if any, influence suicidal behavior.MethodsA retrospective review of patients aged 10–84 with VSH-SA (coded by ICD-10), admitted during a three year period. The cases were sorted by age, gender, year of admission, seasonal pattern, mechanism of injury and associated psychiatric pathology. The mechanisms of injury were both violent and non-violent.Results59% of cases were female and 41% male, 18% under the age of 18 (82% female). 31,5% were in the 18-29 years of age interval. A large difference between the year 2008 (16 cases) and 2009 (51 cases) was registered in the male group. Most cases were registered during spring (34%). Drug and substance ingestion was the most common method. Violent methods were used by 25% of men and only 9,5% of women. The most frequent diagnosis was major depression.ConclusionOur results show that a large number of VSH-SA were committed by young, active members of the population and a significant number of children was noticed. These findings emphasize the importance of identifying suicide risk factors and developing prevention strategies.

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