scholarly journals Deliberate Self-Harm: Clinical and Socio-Economic Characteristics of 368 Patients

1975 ◽  
Vol 127 (6) ◽  
pp. 564-574 ◽  
Author(s):  
H. Gethin Morgan ◽  
Christopher J. Burns-Cox ◽  
Helen Pocock ◽  
Susan Pottle
Keyword(s):  
Antisocial Behaviour ◽  
Alcohol Addiction ◽  
Royal Infirmary ◽  
Age Group ◽  
Deliberate Self Harm ◽  
Functional Psychosis ◽  
Accident And Emergency ◽  
Self Harm ◽  
Accident And Emergency Department ◽  
Previous Occasion

SummaryIn this study 368 patients were interviewed after they had attended the Bristol Royal Infirmary Accident and Emergency Department following a non-fatal act of deliberate self-harm. There were twice as many women (247) as men (121), and two thirds of the patients were in the 15–35 age group. Ninety-five per cent had taken a drug overdose, most commonly one or more of the tranquillizers, antidepressants, hypnotics or analgesics. Seventy-eight per cent had taken drugs prescribed by a doctor. Half the patients mentioned interpersonal conflict as a major precipitating factor in the episode. A psychiatric diagnosis was completed for all admitted patients, of whom 52 per cent were considered to be suffering from neurotic depression, 29 per cent from personality disorder, 12 per cent from functional psychosis and 10 per cent from alcohol addiction. Almost half had deliberately harmed themselves on a previous occasion. The series showed a greater than average incidence of unemployment, overcrowded living conditions, divorce and antisocial behaviour. The implications of these findings for the clinical management and prevention of non-fatal deliberate self-harm are discussed.

scholarly journals Deliberate self-harm and antidepressant drugs

2000 ◽  
Vol 177 (6) ◽  
pp. 551-556 ◽  
Author(s):  
Stuart Donovan ◽  
Andrew Clayton ◽  
Min Beeharry ◽  
Sheron Jones ◽  
Chris Kirk ◽  
...  
Keyword(s):  
Emergency Department ◽  
Prospective Study ◽  
Serotonin Reuptake ◽  
Antidepressant Drugs ◽  
Tricyclic Antidepressant ◽  
Deliberate Self Harm ◽  
Accident And Emergency ◽  
Self Harm ◽  
Accident And Emergency Department ◽  
A Prospective Study

BackgroundIt is not clear if the frequency of deliberate self-harm (DSH) is the same in patients taking different pharmacological classes of antidepressant drugs.AimsTo compare the frequency of DSH in patients who had been prescribed a tricyclic antidepressant (TCA) or a selective serotonin reuptake inhibitor (SSRI) prior to the DSH event.MethodThis was a prospective study in 2776 consecutive DSH cases attending an accident and emergency department. The incidence of DSH in TCA-treated cases and SSRI-treated cases is expressed as number of DSH events per 10 000 prescriptions of each antidepressant.ResultsSignificantly more DSH events occurred following the prescription of an SSRI than that of a TCA (P < 0.001). The occurrence of DSH was highest with fluoxetine and lowest with amitriptyline.ConclusionsMerely prescribing safer-in-overdose antidepressants is unlikely to reduce the overall morbidity from DSH.

The Urban Distribution of Non-Fatal Deliberate Self-Harm

1975 ◽  
Vol 126 (4) ◽  
pp. 319-328 ◽  
Author(s):  
H. Gethin Morgan ◽  
Helen Pocock ◽  
Susan Pottle
Keyword(s):  
Central Area ◽  
Positive Association ◽  
High Rate ◽  
Age Group ◽  
Foreign Born ◽  
Significant Positive Association ◽  
Deliberate Self Harm ◽  
Accident And Emergency ◽  
Self Harm ◽  
The City

Summary1. The incidence of non-fatal deliberate self-harm throughout the City of Bristol during 1972 and 1973 was assessed by means of a survey of patients presenting to Accident and Emergency Departments of hospitals in the area. Fatal or repeated acts of self-harm were not included in the survey. 2. The rates for females exceeded those for males at all ages, with peak incidence of 645 per 100,000 females (age group 15–29 years) and 334 per 100,000 males (age group 25–29 years). Ninety-three per cent had taken a drug overdose of some kind. 3. The problem was found in all electoral wards of the city, though its distribution was markedly centripetal, with a central area having morbidity rates up to 2.8 times that for the city as a whole. 4. The socio-economic correlates of deliberate self-harm were examined by reference both to a series of 368 patients interviewed soon after the event and to the pattern of its distribution throughout the city. A significant positive association was found with areas of overcrowding, lack of exclusive domestic amenities and high proportion of foreign born residents, but there was no correlation with the proportion of persons living alone nor with the type of accommodation. 5. The central high rate area was found to be heterogeneous in socio-economic terms, ranging from a student and young professionals' bed-sitter area to one with a high proportion of unskilled manual labourers and New Commonwealth immigrants. 6. The aetiological implications of the ecological findings for deliberate self-harm throughout the city are discussed.

Suicide and Parasuicide in Childhood and Early Adolescence

1985 ◽  
Vol 146 (5) ◽  
pp. 459-463 ◽  
Author(s):  
Donald J. Brooksbank
Keyword(s):  
Early Adolescence ◽  
Attempted Suicide ◽  
Psychiatric Services ◽  
Age Group ◽  
Deliberate Self Harm ◽  
England And Wales ◽  
The Social ◽  
Self Harm ◽  
Age Range

Suicide is intentional self-killing, and parasuicide an act of deliberate self-harm—either by injury, ingestion or inhalation—not resulting in death (Blacket al,1982). Both are rare under the age of 12 and the rate of suicide in those under 16 remains consistently low. Referrals to psychiatric services reported by Shaffer (1974) indicated that 7–10% were for threatened or attempted suicide, while Hawton (1982) quoted studies giving the incidence as 10–33% for children aged six to 12; in England and Wales (1962–1968), suicide accounted for 0.6% of deaths in the 10–14 age-range. McClure (1984) found that between 1975 and 1980, only ten such deaths were recorded in the 13-and-under range, and 26 deaths in the 14 year-olds, after which the number of suicides rose sharply with each successive year. That study also showed that parasuicide was most common in the 15–24 age-group, but at younger ages there was a higher proportion of undetermined deaths, as against officially recorded suicides. The social taboos associated with suicide may lead to its systematic under-reporting, but even allowing for that, the phenomenon is still a rare one under the age of 16.

Concordance of clinical estimation of suicidal intent

2002 ◽  
Vol 19 (3) ◽  
pp. 84-85 ◽  
Author(s):  
Helen S Keeley ◽  
Carmel McAuliffe ◽  
Paul Corcoran ◽  
Ivan J Perry
Keyword(s):  
Multicentre Study ◽  
Suicidal Intent ◽  
Deliberate Self Harm ◽  
Statistical Comparison ◽  
Accident And Emergency ◽  
Psychometric Instruments ◽  
Suicide Intent ◽  
Self Harm ◽  
Clinical Records ◽  
Level Of Agreement

AbstractObjective: The aim of this paper is to assess the level of agreement between clinical estimates of suicidal intent based entirely on information recorded in the Accident and Emergency acute assessment and Beck's Suicide Intent Scale (SIS) scores.Method: As part of the WHO/EURO Multicentre Study of Parasuicide, cases of deliberate self-harm (DSH) in Cork city hospitals were monitored. Over the period 1995-1997, the information recorded in the Accident and Emergency acute assessment was examined by a psychiatrist and, if possible on the available evidence, clinical estimates were made at three levels of suicidal intent: minimal, moderate and definite. Seventy-nine of these cases had fully completed Beck's SIS. Statistical comparison was made between the results of the SIS and the clinical estimate of suicide intent.Results: The agreement (Kappa = 0.146, p = 0.046) and concordance (Lin's concordance coefficient = 0.330, p = 0.001) between the two ratings are statistically significant but both are low. The overlap between those identified as high or low intent is low.Conclusions: These findings indicate low agreement between a clinician's rating of suicide intent based on clinical records and Beck's SIS. This is especially relevant given the increasing reliance on psychometric instruments in assessment in psychiatry. However, further investigation is necessary to clarify which is the more valid method.

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