Which Neurotic Patients Do Psychiatrists Treat?

1988 ◽  
Vol 152 (2) ◽  
pp. 222-228 ◽  
Author(s):  
John M. Eagles ◽  
David A. Alexander
Keyword(s):  
Alcohol Abuse ◽  
Short Duration ◽  
Psychiatric Treatment ◽  
Deliberate Self Harm ◽  
Factors Associated ◽  
Main Hospital ◽  
Duration Of Illness ◽  
History Of ◽  
Self Harm

Of 336 newly referred neurotic patients, 80 were not offered continuing psychiatric treatment. The factors associated with patients' not being offered continuing treatment were: short duration of illness; history of alcohol abuse and/or deliberate self-harm; age over 50 years; being widowed; and living more than 20 miles from the main hospital complex. The implications of these findings are discussed.

scholarly journals Factors associated with psychiatric treatment dropout in a mental health reference center, Belo Horizonte

2005 ◽  
Vol 27 (2) ◽  
pp. 113-118 ◽  
Author(s):  
Ana Paula Souto Melo ◽  
Mark Drew Crosland Guimarães
Keyword(s):  
Mental Health ◽  
Cox Regression ◽  
Psychiatric Treatment ◽  
Treatment Interruption ◽  
Treatment Dropout ◽  
Factors Associated ◽  
Psychiatric Hospitalizations ◽  
History Of ◽  
Belo Horizonte ◽  
Social Demographic

OBJECTIVE: To characterize an outpatient public referral center for mental health and to assess factors associated with treatment dropout. METHODS: A non-concurrent prospective study was undertaken to review 295 patient files. Patients, whose first consultation took place between January and December 1997, were followed-up for at least four months until April 1998. Patients were considered as having abandoned their treatment when, following a recommendation for at least a second visit, they did not return within four months after the first consultation. Social, demographic and clinical variables were compared to verify possible factors associated with dropout of treatment. Statistical analysis was performed using relative hazard (RR) with 95% confidence interval (CI) estimated by the Cox Regression Model. RESULTS: Cumulative incidence of treatment dropout was 39.2% while multivariate analysis indicated that the following characteristics were statistically associated with treatment interruption: to live outside the referral area (RR = 1.95), no history of previous psychiatric hospitalizations (RR = 1.88), alcohol or drug use at admission (RR = 1.72), spontaneous demand to the service (RR = 2.12), lack of bus-passes (RR = 3.68) and to have less than four clinical appointments (RR = 7.31). CONCLUSIONS: Our findings suggest that services should be aware of the high incidence of treatment interruption, especially among those with no history of previous psychiatric hospitalizations and with less institutional bonds. This may indicate that mental health services should develop and implement public policies targeted at this population.

Differentiating Successful and Unsuccessful Insanity Plea Defendants in Colorado

1987 ◽  
Vol 15 (1) ◽  
pp. 55-71 ◽  
Author(s):  
Richard A. Pasewark ◽  
Richard Jeffrey ◽  
Stephen Bieber
Keyword(s):  
Drug Abuse ◽  
Alcohol Abuse ◽  
Psychiatric Treatment ◽  
Insanity Plea ◽  
History Of

Of 133 Colorado male defendants employing the insanity plea from 1980 to 1983, 36 were adjudicated insane and 97 found guilty. Considering all defendants, they were found to be primarily single, Caucasian, somewhat older and better educated than the usual defendant group, unemployed at the time of the insane offense, and with a history characterized by chronic unemployment, prior psychiatric treatment, drug abuse, alcohol abuse, and previous arrests. Acquittees differed significantly from convicted defendants in being older and better educated. They were more likely to have been diagnosed as schizophrenic and less likely to have had a history of drug abuse. No difference was found between the groups with respect to all other variables examined, including severity of instant offense, ethnicity, and number of prior arrests.

History of Deliberate Self Harm May Predict Methods of Fatal Self Harm in the Elderly

2001 ◽  
Vol 41 (2) ◽  
pp. 107-110 ◽  
Author(s):  
Emad Salib ◽  
George Tadros ◽  
Sheila Cawley
Keyword(s):  
The Elderly ◽  
Deliberate Self Harm ◽  
History Of ◽  
Self Harm

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.

Factors associated with deliberate self-harm among Irish adolescents

2010 ◽  
Vol 40 (11) ◽  
pp. 1811-1819 ◽  
Author(s):  
E. M. McMahon ◽  
U. Reulbach ◽  
P. Corcoran ◽  
H. S. Keeley ◽  
I. J. Perry ◽  
...  
Keyword(s):  
Life Style ◽  
Public Health Problem ◽  
Cross Sectional Study ◽  
Major Public Health Problem ◽  
Cross Sectional ◽  
Life Event ◽  
Deliberate Self Harm ◽  
Factors Associated ◽  
Related Risk ◽  
Self Harm

BackgroundDeliberate self-harm (DSH) is a major public health problem, with young people most at risk. Lifetime prevalence of DSH in Irish adolescents is between 8% and 12%, and it is three times more prevalent among girls than boys. The aim of the study was to identify the psychological, life-style and life event factors associated with self-harm in Irish adolescents.MethodA cross-sectional study was conducted, with 3881 adolescents in 39 schools completing an anonymous questionnaire as part of the Child and Adolescent Self-harm in Europe (CASE) study. There was an equal gender balance and 53.1% of students were 16 years old. Information was obtained on history of self-harm life events, and demographic, psychological and life-style factors.ResultsBased on multivariate analyses, important factors associated with DSH among both genders were drug use and knowing a friend who had engaged in self-harm. Among girls, poor self-esteem, forced sexual activity, self-harm of a family member, fights with parents and problems with friendships also remained in the final model. For boys, experiencing bullying, problems with schoolwork, impulsivity and anxiety remained.ConclusionsDistinct profiles of boys and girls who engage in self-harm were identified. Associations between DSH and some life-style and life event factors suggest that mental health factors are not the sole indicators of risk of self-harm. The importance of school-related risk factors underlines the need to develop gender-specific initiatives in schools to reduce the prevalence of self-harm.

Factors associated with deliberate self-harm behaviour among depressed adolescent outpatients

2009 ◽  
Vol 32 (5) ◽  
pp. 1125-1136 ◽  
Author(s):  
Virpi Tuisku ◽  
Mirjami Pelkonen ◽  
Olli Kiviruusu ◽  
Linnea Karlsson ◽  
Titta Ruuttu ◽  
...  
Keyword(s):  
Deliberate Self Harm ◽  
Factors Associated ◽  
Depressed Adolescent ◽  
Self Harm

Attempted suicide in west London, II. Inter-group comparisons

1999 ◽  
Vol 29 (5) ◽  
pp. 1131-1139 ◽  
Author(s):  
D. BHUGRA ◽  
D. S. BALDWIN ◽  
M. DESAI ◽  
K. S. JACOB
Keyword(s):  
Social Factors ◽  
Social Stress ◽  
Attempted Suicide ◽  
Asian Women ◽  
Culture Conflict ◽  
Deliberate Self Harm ◽  
The United Kingdom ◽  
History Of ◽  
Self Harm ◽  
Group Comparisons

Background. Previous studies of attempted suicide have suggested that cultural and social factors play a significant role in the causation of deliberate self-harm.Method. In order to measure elements of culture conflict two inter-group comparisons were undertaken. In the first, 27 Asian women who had presented to hospital services following attempted suicide (Asian group) were matched with a group of similar age Asian women attending GP surgeries for other reasons (Asian GP attenders group). The second comparison was between the Asian and 46 White attempters.Results. On comparing Asian attempters with Asian GP attenders group the former were more likely to have a history of previous suicidal behaviour, to have a psychiatric diagnosis, and be unemployed. Their parents were more likely to have arrived in the United Kingdom at an older age. In addition, those who attempted suicide were more likely to have been in an inter-racial relationship and to have changed religions. In the second inter-group comparison, the characteristics of Asian and White suicide attempt patients were examined. White attempters were more likely to have mental illness, and were more likely to use alcohol as part of the method of attempted suicide. By contrast, Asian attempters had experienced life events pertaining to relationships, took fewer tablets and yet expressed greater regret at not succeeding in the attempt.Conclusions. Although numbers are small, social stress and other cultural factors play an important role in the act of deliberate self-harm.

Suicide among Psychiatric in-Patients in the Wellington Region

1993 ◽  
Vol 27 (3) ◽  
pp. 392-398 ◽  
Author(s):  
Deborah A. Read ◽  
Christopher S. Thomas ◽  
Graham W. Mellsop
Keyword(s):  
Past History ◽  
Health Board ◽  
Suicidal Risk ◽  
Patient Suicide ◽  
Deliberate Self Harm ◽  
Psychiatric Admissions ◽  
History Of ◽  
Self Harm ◽  
Area Health ◽  
Control Study

To identify risk factors for in-patient suicide, a case-control study of in-patient suicide was conducted in the Wellington Area Health Board region between 1984 and 1989 on 27 cases and 86 controls. The risk of in-patient suicide was increased among individuals who had been compulsorily admitted, suffered from schizophrenia, had a past history of deliberate self harm, had been in hospital for more than a month, or were unmarried. Notably, there was no relationship with physical health, a history of substance abuse, number of psychiatric admissions and time since the last known episode of deliberate self harm. These characteristics can assist clinical assessment of individual suicidal risk. Further evaluation of the relation of compulsory admission to suicide is required.

Termination of Pregnancy and Psychiatric Morbidity

1995 ◽  
Vol 167 (2) ◽  
pp. 243-248 ◽  
Author(s):  
Anne C. Gilchrist ◽  
Philip C. Hannaford ◽  
Peter Frank ◽  
Clifford R. Kay
Keyword(s):  
Social Factors ◽  
Psychiatric Illness ◽  
Unplanned Pregnancy ◽  
Psychiatric Morbidity ◽  
Previous History ◽  
Termination Of Pregnancy ◽  
Factors Associated ◽  
Confounding Variables ◽  
History Of ◽  
Self Harm

BackgroundWe investigated whether reported psychiatric morbidity was increased after termination of pregnancy compared with other outcomes of an unplanned pregnancy.MethodThis was a prospective cohort study of 13 261 women with an unplanned pregnancy. Psychiatric morbidity reported by GPs after the conclusion of the pregnancy was compared in four groups: women who had a termination of pregnancy (6410), women who did not request a termination (6151), women who were refused a termination (379), and women who changed their minds before the termination was performed (321).ResultsRates of total reported psychiatric disorder were no higher after termination of pregnancy than after childbirth. Women with a previous history of psychiatric illness were most at risk of disorder after the end of their pregnancy, whatever its outcome. Women without a previous history of psychosis had an apparently lower risk of psychosis after termination than postpartum (relative risk RR = 0.4, 95% confidence interval CI = 0.3–0.7), but rates of psychosis leading to hospital admission were similar. In women with no previous history of psychiatric illness, deliberate self-harm (DSH) was more common in those who had a termination (RR 1.7, 95%CI 1.1–2.6), or who were refused a termination (RR 2.9, 95%CI 1.3–6.3).ConclusionsThe findings on DSH are probably explicable by confounding variables, such as adverse social factors, associated both with the request for termination and with subsequent self-harm. No overall increase in reported psychiatric morbidity was found.

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