Problems reported by self-harm patients (original) (raw)
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Problem-solving ability and repetition of deliberate self-harm: a multicentre study
Psychological Medicine, 2006
Background. While recent studies have found problem-solving impairments in individuals who engage in deliberate self-harm (DSH), few studies have examined repeaters and non-repeaters separately. The aim of the present study was to investigate whether specific types of problem-solving are associated with repeated DSH.
JPMA. The Journal of the Pakistan Medical Association, 2021
OBJECTIVE To identify the association among suicidal ideation, deliberate self-harm, and psychopathological distress in normal and deliberate self-harm adults. METHODS The cross-sectional study was conducted at the Department of Psychiatry, Military Hospital, Rawalpindi, Pakistan, from January to July 2017, and comprised deliberate self harm and normal adults aged 18-25 years. Psychiatric evaluation involved a semi-structured interview based on mental status examination. The self-harm tendency was assessed on the basis of self-harm inventory of the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders. Beck scale for suicide ideation and he depression anxiety and stress scale were also used for data collection. Data was analysed using SPSS 22. RESULTS There were 200 subjects with a mean age of 20.89±9.06 years; 100(50%) each in deliberate self-harm and normal groups. Deliberate self-harm was significantly positively associated with suicidal ideation and mental h...
Trials, 2014
Background: Around 150,000 people each year attend hospitals in England due to self-harm, many of them more than once. Over 5,000 people die by suicide each year in the UK, a quarter of them having attended hospital in the previous year because of self-harm. Self-harm is a major identifiable risk factor for suicide. People receive variable care at hospital; many are not assessed for their psychological needs and little psychological therapy is offered. Despite its frequent occurrence, we have no clear research evidence about how to reduce the repetition of self-harm. Some people who have self-harmed show less active ways of solving problems, and brief problem-solving therapies are considered the most promising psychological treatments. Methods/Design: This is a pragmatic, individually randomised, controlled, feasibility study comparing interpersonal problem-solving therapy plus treatment-as-usual with treatment-as-usual alone, for adults attending a general hospital following self-harm. A total of 60 participants will be randomised equally between the treatment arms, which will be balanced with respect to the type of most recent self-harm event, number of previous self-harm events, gender and age. Feasibility objectives are as follows: a) To establish and field test procedures for implementing the problem-solving intervention; b) To determine the feasibility and best method of participant recruitment and follow up; c) To assess therapeutic delivery; d) To assess the feasibility of obtaining the definitive trial's primary and secondary outcomes; e) To assess the perceived burden and acceptability of obtaining the trial's self-reported outcome data; f) To inform the sample size calculation for the definitive trial. Discussion: The results of this feasibility study will be used to determine the appropriateness of proceeding to a definitive trial and will allow us to design an achievable trial of interpersonal problem-solving therapy for adults who self-harm. Trial registration: Current Controlled Trials (ISRCTN54036115)
Journal of affective disorders, 2015
Hopelessness is frequently observed in people who harm themselves and is an established risk factor for nonfatal self-harm repetition and suicide. Little is known about how the presence of hopelessness in addition to other risk factors affects subsequent risk. Prospective cohort of 19,479 individuals presenting with self-harm to one of three English Emergency Departments between 1st January 2000 and 31st December 2010. Repeat self-harm and suicide deaths within twelve months of the first assessed episode were identified. Cox Proportional Hazards models were used to estimate Hazard Ratios (HRs) for risk factors with and without hopelessness. A clinical impression of hopelessness was associated with increased risk of further self-harm (HR 1.35, 95% CI 1.16-1.58) and suicide (HR 2.56, CI 1.10-5.96) in the year following an index episode. For individuals who were living alone or homeless, unemployed, reported problems with housing, had received psychiatric treatment in the past, were cu...
Psikiyatri hemşireliği dergisi, 2024
The effect of problem-solving skills education on suicide ideation and self-esteem of inpatients at the psychiatry service: A follow-up study* S uicide occurs in three ways: thoughts to kill oneself, attempts to kill oneself, or to kill oneself. [1,2] Suicide rates in each society have been rising year by year. Annually, more than 700.000 people die of suicide over the world. Globally, 1.4% of cause of deaths were due to suicide. [2-4] Suicide can be seen in all age groups but according to the statistics of 2019, it is the fourth leading cause of death among those aged 15-29 years. [5] A suicide attempt is an act in which an individual tries to kill himself but survives. Many factors such as genetic, neurobiological and familial factors, family suicide history, traumatic experiences, mortal diseases, and secondary diseases that accompany psychiatric diseases lead to suicide attempts. [6,7] Besides, psychiatric diseases such as depression, schizophrenia, alcohol, and substance use pave the way to suicide. [7] Suicide behavior and suicide ideation can Objectives: This study focused on exploring the effect of education program held to improve problem-solving skills for the patients who were hospitalized at a psychiatry service and had suicide ideation upon self-esteem and suicide ideation. Methods: The study was done as a follow-up study with a pre-test, post-test, and control group. The study was conducted with 34 patients-17 patients assigned to the experimental group and 17 patients to the control group. A threesession problem-solving skills development program was held for the patients. The scales were again administered to the patients 3 weeks and 6 weeks later the training and patients were followed-up. The study data were gathered using the "Information Request Form, " "Rosenberg Self-esteem Scale" and "Beck Scale for Suicide Ideation. " Results: In the study, the experimental and the control groups were similar in terms of gender, marital status, educational status, family type, those with whom they lived together, employment status, economic status, suicide history, problem-solving level, and medical diagnosis (p>0.05). After the problem-solving training, there were statistically significant differences among the average suicide ideation scores of the experimental group patients (p<0.05). The experimental group patients' self-esteem scores increased while their suicide ideation scores decreased. In terms of the variables of gender and previous suicide attempts, intragroup comparisons of the patients in the experimental and control groups showed that a statistically significant difference existed between average scores of self-esteem and suicide ideation (p<0.05), however, there was no significant difference in intergroup comparisons (p>0.05). Conclusion: In the study; a three-session problem-solving skills development program was held for the inpatients with suicide ideation and their self-esteem went up while suicide ideation went down.
BMJ, 2005
Objective To explore the accounts of those with a history of deliberate self harm but who no longer do so, to understand how they perceive this resolution and to identify potential implications for provision of health services. Design Qualitative in-depth interview study. Setting Interviews in a community setting. Participants 20 participants selected from a representative cohort identified in 1997 after an episode of deliberate self poisoning that resulted in hospital treatment. Participants were included if they had no further episodes for at least two years before interview. Results We identified three recurrent themes: the resolution of adolescent distress; the recognition of the role of alcohol as a precipitating and maintaining factor in self harm; and the understanding of deliberate self harm as a symptom of untreated or unrecognised illness. Conclusion Patients with a history of deliberate self harm who no longer harm themselves talk about their experiences in terms of lack of control over their lives, either through alcohol dependence, untreated depression, or, in adolescents, uncertainty within their family relationships. Hospital management of deliberate self harm has a role in the identification and treatment of depression and alcohol misuse, although in adolescents such interventions may be less appropriate.
Self-harm and life problems: findings from the Multicentre Study of Self-harm in England
Social psychiatry and psychiatric epidemiology, 2015
Self-harm is a major clinical problem and is strongly linked to suicide. It is important to understand the problems faced by those who self-harm to design effective clinical services and suicide prevention strategies. We investigated the life problems experienced by patients presenting to general hospitals for self-harm. Data for 2000-2010 from the Multicentre Study of Self-harm in England were used to investigate life problems associated with self-harm and their relationship to patient and clinical characteristics, including age, gender, repeat self-harm and employment status. Of 24,598 patients (36,431 assessed episodes), 57 % were female and with a mean age of 33.1 years (SD 14.0 years), 92.6 % were identified as having at least one contributing life problem. The most frequently reported problems at first episode of self-harm within the study period were relationship difficulties (especially with partners). Mental health issues and problems with alcohol were also very common (esp...