scholarly journals Adolescent health and subsequent risk of self-harm hospitalisation: a 15-year follow-up of the Young-HUNT cohort

2017 ◽  
Vol 11 (1) ◽  
Author(s):  
Asbjørn Junker ◽  
Johan Håkon Bjørngaard ◽  
Ottar Bjerkeset
Keyword(s):  
Adolescent Health ◽  
Self Harm ◽  
Subsequent Risk

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 Community mental health care after self-harm: A retrospective cohort study

2016 ◽  
Vol 51 (7) ◽  
pp. 727-735 ◽  
Author(s):  
Matthew J Spittal ◽  
Fiona Shand ◽  
Helen Christensen ◽  
Lisa Brophy ◽  
Jane Pirkis
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Community Mental Health ◽  
Health Services ◽  
Mental Health Care ◽  
Psychiatric Inpatient ◽  
Community Mental Health Services ◽  
Community Mental Health Care ◽  
Self Harm

Objective: Presentation to hospital after self-harm is an opportunity to treat underlying mental health problems. We aimed to describe the pattern of mental health contacts following hospital admission focusing on those with and without recent contact with community mental health services (connected and unconnected patients). Methods: We undertook a data linkage study of all individuals admitted as a general or psychiatric inpatient to hospital after self-harm in New South Wales, Australia, between 2005 and 2011. We identified the proportion of admissions where the patient received subsequent in-person community mental health care within 30 days of discharge and the factors associated with receipt of that care. Results: A total of 42,353 individuals were admitted to hospital for self-harm. In 41% of admissions, the patient had contact with a community mental health service after discharge. Patients connected with community mental health services had 5.33 (95% confidence interval = [5.09, 5.59]) times higher odds of follow-up care than unconnected patients. Other factors, such as increasing age and treatment as a psychiatric inpatient, were associated with lower odds of follow-up community care. Conclusion: Our study suggests that full advantage is not being taken of the opportunity to provide comprehensive mental health care for people who self-harm once they have been discharged from the inpatient setting. This is particularly the case for those who have not previously received community mental health care. There appears to be scope for system-level improvement in the way in which those who are treated for self-harm are followed up in the community.

scholarly journals An empirical investigation of physical literacy-based adolescent health promotion

2021 ◽  
Vol 0 (0) ◽  
Author(s):  
Minmin Du ◽  
Yimin Liu ◽  
Lei Li
Keyword(s):  
Health Promotion ◽  
Adolescent Health ◽  
Panel Survey ◽  
Physical Literacy ◽  
Factors Affecting ◽  
Training Models ◽  
Study Results ◽  
Main Factors ◽  
Physical Elements

Abstract A reexamination of the health problems of Chinese adolescents based on the concept of physical literacy (PL) was necessary. Through the use of follow-up data collected from the China Education Panel Survey 2014–2015, the main factors affecting the health of adolescents were identified, and possible explanations were investigated after cluster and inductive analyses were conducted. The results showed that (1) the 10 main factors identified as affecting adolescent health promotion are in line with the four main elements of PL (emotional, cognitive, social and physical elements) and (2) the three major categories of influencing factors identified through a cluster analysis were aligned with the three main factors of PL (endogeneity, fundamentality and permeability). These findings suggest that the factors influencing adolescent health promotion are closely associated with PL. The study results can provide empirical evidence for adolescent health promotion research and a reference for the development of evidence-based PL training models.

scholarly journals SCHIZOPHRENIA

2016 ◽  
Vol 23 (06) ◽  
pp. 760-762
Author(s):  
Zain Majid ◽  
Anum Haider ◽  
Habib Feroz Kapadia
Keyword(s):  
Early Intervention ◽  
Psychiatric Disorder ◽  
Chronic Schizophrenia ◽  
Elderly Male ◽  
Self Harm

Schizophrenia is a psychiatric disorder and self harm is considered to be a rarepresentation of it. Lack of early intervention is mostly suggestive of leading to it. We herebypresent a case of a elderly male with chronic schizophrenia who came to our ER with thecomplains of self assault one day prior to admission, odd behavior, somatic delusions since 8days, self laughter and self talking since the last 25 years. Being a previously diagnosed caseof schizophrenia, he was non complaint with his previous medications, which worsened hiscondition and led to the patient stabbing himself multiple times after being convinced that therewere snakes in his abdomen. The patient was treated with antipsychotics and benzodiazepines,his family was given psycho education and after being stable for a few weeks, he was laterdischarged and asked to follow up regularly in our OPD.

scholarly journals Adolescent personality traits, low self-esteem and self-harm hospitalisation: a 15-year follow-up of the Norwegian Young-HUNT1 cohort

2018 ◽  
Vol 28 (3) ◽  
pp. 329-339 ◽  
Author(s):  
Asbjørn Junker ◽  
Hans Morten Nordahl ◽  
Johan Håkon Bjørngaard ◽  
Ottar Bjerkeset
Keyword(s):  
Personality Traits ◽  
Self Esteem ◽  
Self Harm ◽  
Adolescent Personality

A systematic review of evidence-based aftercare for older adults following self-harm

2022 ◽  
pp. 000486742110671
Author(s):  
Anne PF Wand ◽  
Roisin Browne ◽  
Tiffany Jessop ◽  
Carmelle Peisah
Keyword(s):  
Older Adults ◽  
Qualitative Studies ◽  
Assessment Tools ◽  
Screening Tools ◽  
Safety Planning ◽  
Level Of Evidence ◽  
Heritage Foundation ◽  
Quality Ratings ◽  
Self Harm

Objective: Self-harm is closely associated with suicide in older adults and may provide opportunity to intervene to prevent suicide. This study aimed to systematically review recent evidence for three components of aftercare for older adults: (1) referral pathways, (2) assessment tools and safety planning approaches and (3) engagement and intervention strategies. Methods: Databases PubMed, Medline, PsychINFO, Embase and CINAHL were searched from January 2010 to 10 July 2021 by two reviewers. Empirical studies reporting aftercare interventions for older adults (aged 60+) following self-harm (including with suicidal intent) were included. Full text of articles with abstracts meeting inclusion criteria were obtained and independently reviewed by three authors to determine final studies for review. Two reviewers extracted data and assessed level of evidence (Oxford) and quality ratings (Alberta Heritage Foundation for Medical Research Standard Quality Assessment Criteria for quantitative and Attree and Milton checklist for qualitative studies), working independently. Results: Twenty studies were reviewed (15 quantitative; 5 qualitative). Levels of evidence were low (3, 4), and quality ratings of quantitative studies variable, although qualitative studies rated highly. Most studies of referral pathways were observational and demonstrated marked variation with no clear guidelines or imperatives for community psychiatric follow-up. Of four screening tools evaluated, three were suicide-specific and one screened for depression. An evidence-informed approach to safety planning was described using cases. Strategies for aftercare engagement and intervention included two multifaceted approaches, psychotherapy and qualitative insights from older people who self-harmed, carers and clinicians. The qualitative studies identified targets for improved aftercare engagement, focused on individual context, experiences and needs. Conclusion: Dedicated older-adult aftercare interventions with a multifaceted, assertive follow-up approach accompanied by systemic change show promise but require further evaluation. Research is needed to explore the utility of needs assessment compared to screening and evaluate efficacy of safety planning and psychotherapeutic approaches.

Deliberate self-harm in a patient with hyperthyroidism with acute psychosis

2021 ◽  
Vol 14 (10) ◽  
pp. e242333
Author(s):  
Haw Huo Wong ◽  
Nicholas Tze Ping Pang
Keyword(s):  
Autoimmune Thyroid Disease ◽  
Radioactive Iodine ◽  
External Genitalia ◽  
Thyroid Stimulating Hormone ◽  
Symphysis Pubis ◽  
Auditory Hallucinations ◽  
Autoimmune Thyroid ◽  
Self Harm ◽  
Iodine Treatment

A woman in her 30s with underlying Graves’ disease, who recently completed radioactive iodine treatment, presented with 2 weeks of acutely altered behaviour associated with auditory hallucinations and religious preoccupations. Laboratory investigation demonstrated elevated free thyroxine levels and suppressed thyroid-stimulating hormone levels. Additionally, there was a presence of antithyroid peroxidase antibodies consistent with autoimmune thyroid disease. She responded to antipsychotics and achieved biochemical euthyroidism. Subsequently, antipsychotic was tapered off during outpatient follow-up at the patient’s own request, with supplement thyroxine continuing. After 1 week, acute hallucinations and religious preoccupations re-emerged, driving her to inflict self-injuries by swallowing coins and nails and banging her head against the wall, sustaining laceration wounds. Furthermore, she hammered a roofing nail into the external genitalia, embedded in the symphysis pubis. After supplemental thyroxine was stopped and olanzapine was started, she achieved biochemical euthyroid followed by remission of psychosis within 1 week. This case illustrates the importance of elucidating organic causes of psychosis as they are easily and swiftly reversible.

Self-harm in the very old one year later: has anything changed?

2019 ◽  
Vol 31 (11) ◽  
pp. 1559-1568 ◽  
Author(s):  
Anne Pamela Frances Wand ◽  
Brian Draper ◽  
Henry Brodaty ◽  
Carmelle Peisah
Keyword(s):  
General Practitioner ◽  
Community Services ◽  
The Self ◽  
Teaching Hospitals ◽  
Very Old ◽  
Inquiry Approach ◽  
Wish To Die ◽  
Self Harm ◽  
One Year

AbstractObjectives:To follow-up a cohort of older people who self-harmed, their carer, and general practitioner (GP) and examine their reflections on the self-harm, care experiences, and outcomes.Design:Qualitative in-depth interviews.Setting:Two teaching hospitals and associated community services.Participants:Twelve-month follow-up of participants aged 80 or older who self-harmed, their nominated carers, and GPs.Measurements:A geriatric psychiatrist gathered data through patient and carer interviews using a narrative inquiry approach and from medical records. Interviews were audio recorded and transcribed. N-VIVO facilitated data organization for thematic analysis. Questionnaires sent to the patient’s GP examined their perspectives and aspects of care relating to the self-harm.Results:Nineteen patients (63% baseline sample), 29 carers (90.6%), and 11 GPs (36.7%) were available at follow-up. Themes emerging from patients were “denial and secrets;” “endless suffering;” “more invalidation;” “being heard;” and “miserable in care.” Themes from carer interviews were “denial and secrets;” “patient’s persistent wish to die;” “abandonment by clinicians;” “unending burden for the carer;” and “distress regarding placement.” General practitioner themes were “the problem is fixed;” “the troops have arrived;” and “I understand.”Conclusions:Factors contributing to self-harm persisted at follow-up. Positive and negative responses were identified in the older person’s system, highlighting areas for potential intervention. A conceptual framework for understanding self-harm in the very old was derived that emphasized the importance of understanding individual needs, the interpersonal context of the older person, and carer burden. Interventions should improve communication, facilitate shared understanding of perspectives, and provide support at all levels.

scholarly journals Comparison of suicide risk and other outcomes among boys and girls who self-harm

2020 ◽  
Vol 29 (12) ◽  
pp. 1741-1746 ◽  
Author(s):  
Anna Ohlis ◽  
Johan Bjureberg ◽  
Paul Lichtenstein ◽  
Brian M. D’Onofrio ◽  
Alan E. Fruzzetti ◽  
...  
Keyword(s):  
Sex Differences ◽  
Suicide Attempts ◽  
Psychiatric Hospitalization ◽  
Economic Status ◽  
Adverse Outcomes ◽  
Hazard Ratios ◽  
Self Harm ◽  
Males And Females ◽  
Drug Use Disorder

Abstract Little is known about sex differences in outcomes of self-harm, and there are inconclusive results concerning the association between sex, self-harm, and suicide attempts. The aim of this study was to explore sex differences in outcomes of self-harm in adolescence. In this cohort study, all individuals (0–17 years) enrolled at the child- and adolescent mental health services (CAMHS) in Stockholm between 2001 and 2015 (N = 110,072) were followed in national registers from their last contact with the CAMHS, until end of 2015. Exposure was self-harm as reason for contact, outcome measures were: alcohol-/substance use disorder, psychiatric hospitalization, non-violent or violent crime, and suicide. Differences in outcomes rates between exposed versus unexposed males, and exposed versus unexposed females, were examined using Cox regressions, expressed as hazard ratios (HR) with 95% confidence intervals (CI). Median follow-up time was 5.8 years (Q1: 2.3 years; Q3: 9.7 years). Self-harm was documented in 2.2% (N = 1241) males and 8.7% (4716) females. Exposed individuals had higher HR for all outcomes as compared with unexposed individuals of their own sex. Exposed females had more pronounced risk for drug use disorder (HR 11.2; 95% CI 9.9–12.7) compared with exposed males (HR 6.5, 95% 5.2–8.0). Both males and females who had engaged in self-harm had elevated risks for future suicide. Adjusting for socio-economic status and age at start of follow-up only marginally affected the associations. Females and males with self-harm had similarly elevated risk for suicide, and self-harm was also an important risk marker for other adverse outcomes within both sexes.

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