Perception on Psychiatric Care Received by Patients Admitted Following Deliberate Self Harm to Three Hospitals in Galle District

Background. Trends in deliberate self-harm (DSH) are important because they have implications for hospital services, may indicate levels of psychopathology in the community and future trends in suicide, and can assist in identification of means of suicide prevention.Method. We have investigated trends in DSH and characteristics of DSH patients between 1990 and 2000 based on data collected through the Oxford Monitoring System for Attempted Suicide.Results. During the 11-year study period 8590 individuals presented following 13858 DSH episodes. The annual numbers of persons and episodes increased overall by 36·3% and 63·1% respectively. Rates (Oxford City) declined, however, in the final 3 years. There were gender- and age-specific changes, with a rise in DSH rates in males aged [ges ]55 years and in females overall and those aged 15–24 years and 35–54 years. Repetition of DSH increased markedly during the study period. Antidepressant overdoses, especially of SSRIs, increased substantially. Paracetamol overdoses declined towards the end of the study period. Alcohol abuse, use of alcohol in association with DSH, and violence increased, especially in females, and the proportion of patients in current psychiatric care and misusing drugs also rose.Conclusions. While overall rates of DSH did not increase markedly between 1990 and 2000, substantial changes in the characteristics of the DSH population and a rise in repetition suggest that the challenges facing clinical services in the management of DSH patients have grown.

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Deliberate Self-Harm: A Follow-Up Study of 279 Patients

The British Journal of Psychiatry ◽

10.1192/bjp.128.4.361 ◽

1976 ◽

Vol 128 (4) ◽

pp. 361-368 ◽

Cited By ~ 70

Author(s):

H. Gethin Morgan ◽

Jacqueline Barton ◽

Susan Pottle ◽

Helen Pocock ◽

Christopher J. Burns-Cox

Keyword(s):

Clinical Management ◽

Psychiatric Care ◽

Psychiatric Treatment ◽

Criminal Record ◽

Deliberate Self Harm ◽

Follow Up Study ◽

Patient Appointment ◽

Self Harm ◽

Initial Episode

SummaryTwo-hundred-and-seventy-nine patients (103 men, 176 women) were followed-up 1–2 years after an act of non-fatal deliberate self-harm. Of 155 patients offered a psychiatric out-patient appointment at the time, only 68 completed the treatment. A further act of deliberate self-harm was committed by 26 men and 41 women within twelve months. The factors most highly associated with repetition were previous psychiatric treatment, a previous act of deliberate self-harm, and a criminal record. These factors held good for a separate series of patients. Significantly more repeaters received prolonged psychiatric care after the initial episode of deliberate self-harm. The implications of these findings for the clinical management of such patients are discussed.

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Deliberate self-harm

Psychiatric Bulletin ◽

10.1192/pb.25.3.98 ◽

2001 ◽

Vol 25 (3) ◽

pp. 98-101 ◽

Cited By ~ 10

Author(s):

Sean Whyte ◽

Andrew Blewett

Keyword(s):

Mental State ◽

Psychiatric Care ◽

Case Note ◽

Clinical Implications ◽

Deliberate Self Harm ◽

Accident And Emergency ◽

Self Harm ◽

Medical Wards ◽

The Impact

Aims and MethodA repetition after 5 years of a prospective case note audit, looking at the impact of a recently established deliberate self-harm (DSH) assessment team on the quality of DSH assessments at Kettering general hospital.ResultsAspecialist DSH team achieved improvement in the quality of psychiatric assessments for the majority of patients who harmed themselves. Assessments of mental state by accident and emergency (A & E) and medical staff before referral to the psychiatric team remain problematic.Clinical ImplicationsSetting up aspecialist team to assess patients who harm themselves can improve the quality of the psychiatric care they receive, but emphasis must still be placed on an adequate assessment of mental state by medical and nursing staff in A&E and on medical wards.

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Coping Style as a Mediator of the Relationship Between Depressive Symptoms and Deliberate Self-Harm

Crisis ◽

10.1027/0227-5910/a000083 ◽

2011 ◽

Vol 32 (5) ◽

pp. 272-279 ◽

Cited By ~ 9

Author(s):

Allison S. Christian ◽

Kristen M. McCabe

Keyword(s):

Depressive Symptoms ◽

Undergraduate Students ◽

Cross Sectional Study ◽

Self Report ◽

Hierarchical Regression ◽

Cross Sectional ◽

Deliberate Self Harm ◽

Self Blame ◽

Self Harm ◽

The Relationship

Background: Deliberate self-harm (DSH) occurs with high frequency among clinical and nonclinical youth populations. Although depression has been consistently linked with the behavior, not all depressed individuals engage in DSH. Aims: The current study examined maladaptive coping strategies (i.e., self-blame, distancing, and self-isolation) as mediators between depression and DSH among undergraduate students. Methods: 202 students from undergraduate psychology courses at a private university in Southern California (77.7% women) completed anonymous self-report measures. Results: A hierarchical regression model found no differences in DSH history across demographic variables. Among coping variables, self-isolation alone was significantly related to DSH. A full meditational model was supported: Depressive symptoms were significantly related to DSH, but adding self-isolation to the model rendered the relationship nonsignificant. Limitations: The cross-sectional study design prevents determination of whether a casual relation exists between self-isolation and DSH, and obscures the direction of that relationship. Conclusions: Results suggest targeting self-isolation as a means of DSH prevention and intervention among nonclinical, youth populations.

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Negative Life Events Associated With Deliberate Self-Harm in an African Population in Uganda

Crisis ◽

10.1027/0227-5910.26.1.4 ◽

2005 ◽

Vol 26 (1) ◽

pp. 4-11 ◽

Cited By ~ 24

Author(s):

E. Kinyanda ◽

H. Hjelmeland ◽

S. Musisi

Keyword(s):

Life Events ◽

Negative Life Events ◽

Life Time ◽

Later Life ◽

Dose Effect ◽

Deliberate Self Harm ◽

Time Period ◽

Significant Difference ◽

Self Harm ◽

Suicide Interventions

Abstract. Negative life events associated with deliberate self-harm (DSH) were investigated in an African context in Uganda. Patients admitted at three general hospitals in Kampala, Uganda were interviewed using a Luganda version (predominant language in the study area) of the European Parasuicide Study Interview Schedule I. The results of the life events and histories module are reported in this paper. The categories of negative life events in childhood that were significantly associated with DSH included those related to parents, significant others, personal events, and the total negative life events load in childhood. For the later-life time period, the negative life events load in the partner category and the total negative life events in this time period were associated with DSH. In the last-year time period, the negative life events load related to personal events and the total number of negative life events in this time period were associated with DSH. A statistically significant difference between the cases and controls for the total number of negative life events reported over the entire lifetime of the respondents was also observed, which suggests a dose effect of negative life events on DSH. Gender differences were also observed among the cases. In conclusion, life events appear to be an important factor in DSH in this cultural environment. The implication of these results for treatment and the future development of suicide interventions in this country are discussed.

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Non-Fatal Deliberate Self-Harm in Three Remote Indigenous Communities in Far North Queensland, Australia

Crisis ◽

10.1027/0227-5910/a000589 ◽

2019 ◽

Vol 40 (6) ◽

pp. 422-428 ◽

Cited By ~ 1

Author(s):

Chris Rouen ◽

Alan R. Clough ◽

Caryn West

Keyword(s):

Health Care ◽

Primary Health Care ◽

Care Center ◽

Indigenous Communities ◽

Indigenous Australians ◽

Deliberate Self Harm ◽

Health Care Center ◽

Far North ◽

Primary Health ◽

Self Harm

Abstract. Background: Indigenous Australians experience a suicide rate over twice that of the general population. With nonfatal deliberate self-harm (DSH) being the single most important risk factor for suicide, characterizing the incidence and repetition of DSH in this population is essential. Aims: To investigate the incidence and repetition of DSH in three remote Indigenous communities in Far North Queensland, Australia. Method: DSH presentation data at a primary health-care center in each community were analyzed over a 6-year period from January 1, 2006 to December 31, 2011. Results: A DSH presentation rate of 1,638 per 100,000 population was found within the communities. Rates were higher in age groups 15–24 and 25–34, varied between communities, and were not significantly different between genders; 60% of DSH repetitions occurred within 6 months of an earlier episode. Of the 227 DSH presentations, 32% involved hanging. Limitations: This study was based on a subset of a larger dataset not specifically designed for DSH data collection and assesses the subset of the communities that presented to the primary health-care centers. Conclusion: A dedicated DSH monitoring study is required to provide a better understanding of DSH in these communities and to inform early intervention strategies.

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