scholarly journals A Comparison of Presentations with Self-Harm to Hospital in Lithuania and Ireland

2021 ◽  
Vol 18 (5) ◽  
pp. 2418
Author(s):  
Samah Kamal ◽  
Mark McGovern ◽  
Aida Kunideliene ◽  
Patricia Casey ◽  
Anne M. Doherty
Keyword(s):  
Mental Illness ◽  
Risk Factor ◽  
Cultural Context ◽  
Substance Misuse ◽  
Adjustment Disorder ◽  
Psychotropic Medications ◽  
Psychiatric History ◽  
Clinical Diagnoses ◽  
Self Harm ◽  
Reduce Risk

Suicide is a serious problem globally, especially in Europe, with suicide rates varying between different countries. Self-harm is a known risk factor for dying by suicide and represents an opportunity to intervene in order to treat any associated mental illness and reduce risk. This study aimed to compare the characteristics of people presenting to hospital with self-harm at two clinical sites: Galway, Ireland and Kaunas, Lithuania. Data were obtained from the services’ database and anonymised for analysis. Over a 5-month period, 89 patients presented with self-harm at the Lithuanian site and 224 patients presented with self-harm at the Irish site. This study found significant differences in presentation, diagnosis and treatment between the two sites. All patients at the Lithuanian site were admitted to psychiatry, compared to 22% of patients at the Irish site (p < 0.001). In Lithuania, the main clinical diagnoses were adjustment disorder (37.1%) and major depression (20.2%), compared to substance misuse being the main clinical diagnosis (33.8%) in Ireland (p < 0.001). There were significant differences in the prescription of psychotropic medications (which were three times more commonly prescribed at the Lithuanian site) after controlling for age, gender and psychiatric history (p < 0.001). Further research is required to understand the cultural context behind and further association between hospitalisation and future death by suicide.

scholarly journals Characteristics of patients admitted to in-patient psychiatric care following parasuicide

1997 ◽  
Vol 21 (11) ◽  
pp. 695-698
Author(s):  
Polash Shajahan ◽  
Katharine Logan ◽  
George Masterton
Keyword(s):  
Mental Illness ◽  
Substance Misuse ◽  
Psychiatric Care ◽  
Acute Stress ◽  
Adjustment Disorder ◽  
Stress Reaction ◽  
Case Note ◽  
Acute Stress Reaction ◽  
Case Note Review ◽  
Psychiatric Outcome

Parasuicide referrals and subsequent transfers to psychiatric in-patient care were recorded for January to April, 1972 to 1996. Information regarding the psychiatric outcome of transfers for the years 1985, 1990 and 1994 was obtained by case note review. Parasuicide referrals show a decline from 1972 to 1990 but they have more than doubled since then. Referrals transferred to in-patient psychiatric care fell from 10.7 to 2.8% during 1985 to 1994. Fewer patients with acute stress reaction, adjustment disorder, personality disorder and substance misuse are being transferred. Transfers of patients with ‘severe mental illness' have remained constant.

Interbirth spacing and offspring mental health outcomes

2012 ◽  
Vol 42 (12) ◽  
pp. 2511-2521 ◽  
Author(s):  
D. V. Riordan ◽  
C. Morris ◽  
J. Hattie ◽  
C. Stark
Keyword(s):  
Mental Illness ◽  
Psychotic Disorder ◽  
Substance Misuse ◽  
Psychotic Disorders ◽  
Cox Regression ◽  
Maternal Stress ◽  
Birth Intervals ◽  
Increased Risk ◽  
Self Harm ◽  
Postnatal Environment

BackgroundThe perinatal or early life environment may influence the development of mental illness in adulthood. It is not clear how, or when, any such influences might be mediated. Foetal exposure to maternal stress in the intrauterine environment has been suggested as a possible mediator of foetal origins of mental illness but the postnatal environment may also be of importance. This study aimed to test the foetal origins hypothesis by using retrograde and antegrade interbirth intervals (time to mother's most recent and next deliveries respectively) as proxy measures of antenatal and postnatal maternal stress.MethodLinked datasets of the Scottish Morbidity Record (SMR) were used to identify a birth cohort. Where applicable, the dates of each mother's most recent previous and/or next subsequent delivery were noted, allowing birth intervals to be calculated. The cohort was followed up into young adulthood, using self-harm, substance misuse, psychotic disorder and affective disorder as outcome measures. Data were analysed using Cox regression.ResultsNo significant relationship was observed between affective disorders and interbirth interval, neither retrograde nor antegrade. Short (<18-month) antegrade birth intervals were independently associated with increased risk of psychotic disorder and self-harm. Long (>72-month) retrograde intervals were associated with increased risk of self-harm and substance misuse.ConclusionsThe data do not provide evidence for the foetal origins of mental disorders but, in the cases of psychotic disorders, and of self-harm, suggest that the early postnatal rather than the antenatal environment may be of greater importance.

scholarly journals Relationship between prescribed psychotropic medications and co-ingested alcohol in intentional self-poisonings

2017 ◽  
Vol 210 (3) ◽  
pp. 203-208 ◽  
Author(s):  
Kate M. Chitty ◽  
Timothy Dobbins ◽  
Andrew H. Dawson ◽  
Geoffrey K. Isbister ◽  
Nicholas A. Buckley
Keyword(s):  
Risk Factor ◽  
Alcohol Consumption ◽  
Odds Ratio ◽  
Psychiatric Illness ◽  
Psychotropic Medications ◽  
Cross Sectional ◽  
Factors Associated ◽  
Acute Distress ◽  
Self Harm ◽  
Sectional Analysis

BackgroundAcute alcohol consumption is a major risk factor for suicide, therefore investigating factors associated with alcohol-related self-harm warrant attention.AimsTo investigate the influence of prescribed psychotropic medications on the odds of co-ingesting alcohol preceding or during intentional efforts to self-poison.MethodA cross-sectional analysis of consecutive hospital presentations following intentional self-poisoning was conducted. A total of 7270 patients (4363 women) aged 18–96 were included.ResultsThe odds of alcohol co-ingestion were increased in those not prescribed any medication (odds ratio (OR) = 1.27, 99% CI 1.10–1.46, P50.001) and in impulsive self-poisonings (OR= 1.39, 99% CI 1.11–1.74, P50.001). Odds were decreased in those prescribed anticonvulsants (OR = 0.69, 99% CI 0.51–0.93), antipsychotics (OR = 0.55, 99% CI 0.45–0.66) and antidepressants (OR = 0.87, 99% CI 0.77–0.99).ConclusionsFindings indicate that being medicated for a psychiatric illness may reduce the likelihood of alcohol consumption during times of acute distress, hence perhaps may reduce the risk of intentional self-poisoning.

Fool’s Gold: Psychologists Using Disingenuous Reasoning to Mislead Legislatures into Granting Psychologists Prescriptive Authority

2003 ◽  
Vol 29 (4) ◽  
pp. 489-524
Author(s):  
Brent Pollitt
Keyword(s):  
Primary Care ◽  
Mental Illness ◽  
Nurse Practitioners ◽  
Primary Care Physicians ◽  
American Psychological Association ◽  
The United States ◽  
Psychotropic Medications ◽  
American Psychological ◽  
Training Requirements ◽  
Prescriptive Authority

Mental illness is a serious problem in the United States. Based on “current epidemiological estimates, at least one in five people has a diagnosable mental disorder during the course of a year.” Fortunately, many of these disorders respond positively to psychotropic medications. While psychiatrists write some of the prescriptions for psychotropic medications, primary care physicians write more of them. State legislatures, seeking to expand patient access to pharmacological treatment, granted physician assistants and nurse practitioners prescriptive authority for psychotropic medications. Over the past decade other groups have gained some form of prescriptive authority. Currently, psychologists comprise the primary group seeking prescriptive authority for psychotropic medications.The American Society for the Advancement of Pharmacotherapy (“ASAP”), a division of the American Psychological Association (“APA”), spearheads the drive for psychologists to gain prescriptive authority. The American Psychological Association offers five main reasons why legislatures should grant psychologists this privilege: 1) psychologists’ education and clinical training better qualify them to diagnose and treat mental illness in comparison with primary care physicians; 2) the Department of Defense Psychopharmacology Demonstration Project (“PDP”) demonstrated non-physician psychologists can prescribe psychotropic medications safely; 3) the recommended post-doctoral training requirements adequately prepare psychologists to prescribe safely psychotropic medications; 4) this privilege will increase availability of mental healthcare services, especially in rural areas; and 5) this privilege will result in an overall reduction in medical expenses, because patients will visit only one healthcare provider instead of two–one for psychotherapy and one for medication.

SELF-HARM IN ADOLESCENCE

2020 ◽  
Author(s):  
Remus Runcan ◽  
Patricia Luciana Runcan ◽  
Cosmin Goian ◽  
Bogdan Nadolu ◽  
Mihaela Gavrilă Ardelean
Keyword(s):  
Substance Misuse ◽  
Deliberate Self Harm ◽  
The People ◽  
Self Harm ◽  
Relationship Of ◽  
The Relationship

This study provides the synonyms for the terms deliberate self-harm and self-destructive behaviour, together with a psychological portrait of self-harming adolescents, the consequence of self-harm, the purpose of self-harm, and the forms of self-harm. It also presents the results of a survey regarding the prevalence of people with non-suicidal self-harming behaviour, the gender of people with non-suicidal self-harming behaviour, the age of the first non-suicidal self-harming behaviour in these people, the frequency of non-suicidal self-harming behaviour in these people, the association of the non-suicidal self-harming behaviour with substance misuse in these people, the relationships of the people with non-suicidal self-harming behaviour with their fathers, mothers, and siblings, the relationships of the people with non-suicidal self-harming behaviour with their friends, the possible causes of self-harming behaviour in these people, and the relationship of people with non-suicidal self-harming behaviour with religion. Some of the results confirmed literature results, while others shed a new light on other aspects related to people with non-suicidal self-harming behaviour

Mental Illness Self-stigma: A Risk Factor of Mental Rehabilitation

2013 ◽  
Vol 20 (9) ◽  
pp. 1448-1456
Author(s):  
TONG YUE ◽  
Xiao-Gang WANG ◽  
Xi-Ting HUANG
Keyword(s):  
Mental Illness ◽  
Risk Factor

scholarly journals Mendelian randomisation for psychiatry: how does it work, and what can it tell us?

2021 ◽  
Author(s):  
Robyn E. Wootton ◽  
Hannah J. Jones ◽  
Hannah M. Sallis
Keyword(s):  
Risk Factors ◽  
Mental Illness ◽  
Risk Factor ◽  
Low Cost ◽  
Sensitivity Analyses ◽  
Mendelian Randomisation ◽  
Naturally Occurring ◽  
Complementary Approach ◽  
Randomised Control Trials ◽  
Successful Prevention

AbstractThe successful prevention of mental illness relies upon the identification of causal, modifiable risk factors. However, observational evidence exploring such risk factors often produces contradictory results and randomised control trials are often expensive, time-consuming or unethical to conduct. Mendelian randomisation (MR) is a complementary approach that uses naturally occurring genetic variation to identify possible causal effects between a risk factor and an outcome in a time-efficient and low-cost manner. MR utilises genetic variants as instrumental variables for the risk factor of interest. MR studies are becoming more frequent in the field of psychiatry, warranting a reflection upon both the possibilities and the pitfalls. In this Perspective, we consider several limitations of the MR method that are of particular relevance to psychiatry. We also present new MR methods that have exciting applications to questions of mental illness. While we believe that MR can make an important contribution to the field of psychiatry, we also wish to emphasise the importance of clear causal questions, thorough sensitivity analyses, and triangulation with other forms of evidence.

scholarly journals Blind spots in stigma research? Broadening our perspective on mental illness stigma by exploring ‘what matters most’ in modern Western societies

2021 ◽  
Vol 30 ◽  
Author(s):  
G. Schomerus ◽  
M. C. Angermeyer
Keyword(s):  
Mental Illness ◽  
Cultural Context ◽  
Value Orientations ◽  
Mental Illness Stigma ◽  
Full Potential ◽  
Qualitative Work ◽  
Conservative Values ◽  
Stigma Experiences ◽  
Blind Spots ◽  
What Matters

Abstract Aims The theory of ‘what matters most’ (WMM) has been developed to understand differences in mental illness stigma between cultures, postulating that stigma becomes most pervasive in situations that matter most in a specific cultural context. The rise of populism in Western societies demonstrates that also within one cultural context, different values ‘matter most’ to different groups. We expand the WMM framework to explore the spectrum of stigma manifestations within Western societies, relating it to both conservative/authoritarian and liberal/modern values. From our findings, we will develop hypotheses on how further research into value orientations and stigma might address potential blind spots in stigma research. Methods Based on a narrative review of the literature on mental illness stigma and value orientations, we apply the WMM framework to cultural mechanisms of stigma within modern Western societies. Results There are several studies showing an association between traditional, authoritarian, conservative values with stronger mental illness stigma, while studies examining the stigma within liberal, modern value orientations are scarce. We hypothesise on situations where encountering a person with mental illness could threaten liberal values and thus might provoke stigma among persons with such value orientations. For example, living with a person with mental illness could be seen as consuming energy and time, thereby jeopardising ‘self-actualisation’, the modern value of realising one's own full potential. As a result, a person highly valuing self-actualisation might try to avoid contact with persons with mental illness. Instances of potential ‘liberal stigma’ also include structural stigma or self-stigma, when, e.g. changing assumptions of what is considered ‘normal’ increase perceptions of being fundamentally different when experiencing mental illness. Conclusions ‘WMM’ appears to be a useful framework to direct research to potential blind spots within the field of stigma research. Looking at instances where liberal values conflict with dealing with a person with mental illness could provide a more comprehensive understanding of stigma experiences among persons with mental illness. However, for measuring stigma, tapping into liberal variations of mental illness stigma is methodologically challenging. Qualitative work could be the first step to elicit potential stigma experiences based on conflicts with liberal values.

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