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1.
Yonsei Med J ; 62(2): 159-163, 2021 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-33527795

RESUMO

PURPOSE: Nearly one third of all patients with an eating disorder (ED) present with non-suicidal self-injury (NSSI). Although it is necessary to pay attention clinically to NSSI in ED patients due to an increased suicidal risk, there are limited data on potential predictors of NSSI in ED. We conducted this study to uncover predictors of NSSI in ED. MATERIALS AND METHODS: A total of 1355 ED patients who visited an ED clinic was evaluated through structured interviews by psychiatrists. The demographic and clinical characteristics of ED patients with NSSI (NSSI group) and ED patients without NSSI (non-NSSI group) were analyzed to identify potential predictors of NSSI in ED. RESULTS: Among all ED individuals, 242 (17.9%) reported a history of NSSI. Compared to the non-NSSI group, the NSSI group reported more severe eating symptomatology, more comorbid psychiatric disease, and more suicidal risk. Comorbid alcohol use disorder, depressive disorder, purging behavior, history of suicide attempt, and rumination symptoms were uncovered as predictors of NSSI in ED. CONCLUSION: The findings of the study are meaningful in that they highlight predictors of NSSI in ED in a large clinical sample. Understanding risk factors of NSSI and offering appropriate interventions are important to preventing suicidality in ED.


Assuntos
Transtornos da Alimentação e da Ingestão de Alimentos/psicologia , Comportamento Autodestrutivo/diagnóstico , Adolescente , Feminino , Humanos , Fatores de Risco , Comportamento Autodestrutivo/psicologia , Ideação Suicida , Tentativa de Suicídio/psicologia , Adulto Jovem
2.
Curr Urol Rep ; 22(3): 18, 2021 Feb 03.
Artigo em Inglês | MEDLINE | ID: mdl-33534050

RESUMO

PURPOSE OF REVIEW: Self-induced genital trauma is rare, and prompt and evidence-based early intervention can improve the urinary and sexual function of these complex patients. This review has surveyed current literature and treatment trends to evaluate the clinical approach to managing genital trauma. RECENT FINDINGS: A literature review was performed regarding self-induced genitalia trauma and trauma management between 2000 and 2019 using MEDLINE® database, the Cochrane Library® Central Search, Web of Science, and Google Scholar. In total, 42 articles were considered relevant and included in this review. Self-induced trauma can be appropriately managed with a multidisciplinary approach. Treatment goals are to preserve urinary, sexual, and reproductive function. Specific evaluation includes mechanism of injury, imaging, and determining the extent of injury and surgical repair, if indicated. Due to the rarity of these injuries and their emergent nature, much of the management is based on retrospective data. Further research is needed to improve long-term functional outcomes in trauma patients.


Assuntos
Genitália/lesões , Comportamento Autodestrutivo , Sistema Urinário/lesões , Feminino , Genitália/cirurgia , Humanos , Masculino , Comportamento Autodestrutivo/complicações , Comportamento Autodestrutivo/diagnóstico , Comportamento Autodestrutivo/psicologia , Comportamento Autodestrutivo/terapia , Sistema Urinário/cirurgia
6.
Psychiatry Res ; 296: 113654, 2021 02.
Artigo em Inglês | MEDLINE | ID: mdl-33360965

RESUMO

The COVID-19 pandemic put global medical systems under massive pressure for its uncertainty, severity, and persistence. For detecting the prevalence of suicidal and self-harm ideation (SSI) and its related risk factors among hospital staff during the COVID-19 pandemic, this cross-sectional study collected the sociodemographic data, epidemic-related information, the psychological status and need, and perceived stress and support from 11507 staff in 46 hospitals by an online survey from February 14 to March 2, 2020. The prevalence of SSI was 6.47%. Hospital staff with SSI had high family members or relatives infected number and the self-rated probability of infection. Additionally, they had more perceived stress, psychological need, and psychological impact. On the contrary, hospital staff without SSI reported high self-rated health, willingness to work in a COVID-19 ward, confidence in defeating COVID-19, and perceived support. Furthermore, they reported better marital or family relationship, longer sleep hours, and shorter work hours. The infection of family members or relatives, poor marital status, poor self-rated health, the current need for psychological intervention, perceived high stress, perceived low support, depression, and anxiety were independent factors to SSI. A systematic psychological intervention strategy during a public health crisis was needed for the hospital staff's mental well-being.


Assuntos
Transtornos de Ansiedade/epidemiologia , Grupo com Ancestrais do Continente Asiático/estatística & dados numéricos , Transtorno Depressivo/epidemiologia , Recursos Humanos em Hospital/estatística & dados numéricos , Comportamento Autodestrutivo/epidemiologia , Ideação Suicida , Adulto , Transtornos de Ansiedade/psicologia , Grupo com Ancestrais do Continente Asiático/psicologia , China , Estudos Transversais , Transtorno Depressivo/psicologia , Feminino , Humanos , Incidência , Masculino , Recursos Humanos em Hospital/psicologia , Comportamento Autodestrutivo/psicologia , Incerteza , Adulto Jovem
7.
Artigo em Inglês | MEDLINE | ID: mdl-33348636

RESUMO

(1) Purpose: Non-suicidal self-injury (NSSI) possibly emerges as well as remits in adolescence. To explore the development and transition of NSSI, this study examined the association between a wide range of interpersonal and intrapersonal predictors of NSSI initiation and cessation. (2) Methods: Chinese adolescents (N = 913) completed self-reported surveys at baseline and at a six-month follow-up. The sample included 625 adolescents who reported no NSSI and 288 adolescents who reported engagement in NSSI at baseline. (3) Results: Among the adolescents without NSSI at baseline, 24.3% engaged in NSSI at follow-up (NSSI initiation group). Among the adolescents with NSSI at baseline, 33.3% reported no NSSI at follow-up (NSSI cessation group). Loneliness, beliefs about adversity, problem behavior, and prosocial behavior were the significant factors in predicting subsequent NSSI initiation. None of the potential predicting factors were associated with subsequent NSSI cessation. (4) Conclusions: These results indicate the importance of intrapersonal factors in Chinese culture, which could be used to identify at-risk adolescents and to design interventions.


Assuntos
Comportamento do Adolescente/psicologia , Relações Interpessoais , Solidão/psicologia , Comportamento Autodestrutivo/etnologia , Comportamento Autodestrutivo/psicologia , Adolescente , Comportamento do Adolescente/etnologia , China/epidemiologia , Feminino , Humanos , Masculino , Grupo Associado , Estudos Prospectivos , Fatores de Risco , Comportamento Autodestrutivo/epidemiologia , Inquéritos e Questionários
8.
PLoS One ; 15(12): e0243860, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33370320

RESUMO

Engaging in facial emotion mimicry during social interactions encourages empathy and functions as a catalyst for interpersonal bonding. Decreased reflexive mirroring of facial expressions has been observed in individuals with different non-psychotic disorders, relative to healthy controls. Given reports of interpersonal relationship difficulties experienced by those who engage in non-suicidal self-injury (NSSI), it is of interest to explore facial emotion mimicry in individuals with a history of this behaviour (HNSSI). Among other things, this will enable us to better understand their emotion regulation and social interaction challenges. Surface facial electromyography (fEMG) was used to record the reflexive facial mimicry of 30 HNSSI and 30 controls while they passively observed a series of dynamic facial stimuli showing various facial expressions of emotion. Beginning with a neutral expression, the stimuli quickly morphed to one of 6 prototypic emotional expressions (anger, fear, surprise, disgust, happiness, or sadness). Mimicry was assessed by affixing surface electrodes to facial muscles known to exhibit a high degree of electrical activity in response to positive and negative emotions: the corrugator supercilii and the zygomaticus major. HNSSI participants, relative to controls, exhibited significantly less electrical activity in the corrugator muscle in response to viewing angry stimuli, and significantly less of an expected relaxation in muscle activity in response to viewing happy stimuli. Mirroring these results, greater endorsement of social influence as a motivator for engaging in NSSI was associated with less mimicry, and greater endorsement of emotion regulation as a motivator was associated with greater incongruent muscle response when viewing happy faces. These findings lend support to the theory that social interaction difficulties in HNSSI might be related to implicit violations of expected social rules exhibited through facial mimicry nonconformity.


Assuntos
Eletromiografia , Emoções , Comportamento Autodestrutivo/psicologia , Adolescente , Análise de Variância , Eletrodos , Face , Feminino , Humanos , Masculino , Músculos/fisiopatologia , Adulto Jovem
9.
PLoS One ; 15(12): e0243467, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33382713

RESUMO

BACKGROUND: A priority for health services is to reduce self-harm in young people. Predicting self-harm is challenging due to their rarity and complexity, however this does not preclude the utility of prediction models to improve decision-making regarding a service response in terms of more detailed assessments and/or intervention. The aim of this study was to predict self-harm within six-months after initial presentation. METHOD: The study included 1962 young people (12-30 years) presenting to youth mental health services in Australia. Six machine learning algorithms were trained and tested with ten repeats of ten-fold cross-validation. The net benefit of these models were evaluated using decision curve analysis. RESULTS: Out of 1962 young people, 320 (16%) engaged in self-harm in the six months after first assessment and 1642 (84%) did not. The top 25% of young people as ranked by mean predicted probability accounted for 51.6% - 56.2% of all who engaged in self-harm. By the top 50%, this increased to 82.1%-84.4%. Models demonstrated fair overall prediction (AUROCs; 0.744-0.755) and calibration which indicates that predicted probabilities were close to the true probabilities (brier scores; 0.185-0.196). The net benefit of these models were positive and superior to the 'treat everyone' strategy. The strongest predictors were (in ranked order); a history of self-harm, age, social and occupational functioning, sex, bipolar disorder, psychosis-like experiences, treatment with antipsychotics, and a history of suicide ideation. CONCLUSION: Prediction models for self-harm may have utility to identify a large sub population who would benefit from further assessment and targeted (low intensity) interventions. Such models could enhance health service approaches to identify and reduce self-harm, a considerable source of distress, morbidity, ongoing health care utilisation and mortality.


Assuntos
Aprendizado de Máquina , Serviços de Saúde Mental , Comportamento Autodestrutivo/prevenção & controle , Adolescente , Adulto , Antipsicóticos/uso terapêutico , Área Sob a Curva , Transtorno Bipolar/tratamento farmacológico , Transtorno Bipolar/psicologia , Criança , Feminino , Humanos , Masculino , Transtornos Psicóticos/tratamento farmacológico , Transtornos Psicóticos/psicologia , Curva ROC , Comportamento Autodestrutivo/psicologia , Ideação Suicida , Adulto Jovem
10.
Anesth Analg ; 131(5): 1421-1429, 2020 11.
Artigo em Inglês | MEDLINE | ID: mdl-33079866

RESUMO

BACKGROUND: Previous research suggests that, compared with regional anesthesia, general anesthesia is associated with increased odds of postoperative depressive disorders. No study has specifically evaluated the possible protective effect of neuraxial anesthesia for cesarean delivery on maternal mental health compared with general anesthesia. This exploratory study was designed to test the hypothesis that general anesthesia for cesarean delivery is associated with increased odds of severe postpartum depression (PPD) requiring hospitalization compared with neuraxial anesthesia. METHODS: This retrospective cohort study included cesarean delivery cases performed in New York State hospitals between January 2006 and December 2013. Exclusion criteria were as follows: (1) having >1 cesarean delivery during the study period; (2) residing outside of New York State; (3) having a general anesthetic for other surgery or delivery in the previous year or in the year after the index case. The primary outcome was the occurrence of PPD, and the secondary outcomes were: (1) the composite of suicidal ideation or self-inflicted injury (ie, suicidality); (2) anxiety disorders; and (3) posttraumatic stress disorders (PTSD). Primary and secondary outcomes were identified during the delivery hospitalization and up to 1 year after delivery. Adjusted odds ratios (aORs) and 95% confidence interval (CI) of adverse psychiatric outcomes associated with general anesthesia were estimated using propensity score matching. RESULTS: Of the 428,204 cesarean delivery cases included, 34,356 had general anesthesia (8.0%). Severe PPD requiring hospitalization was recorded in 1158 women (2.7/1000; 95% CI, 2.5-2.9); of them, 60% were identified during readmission, with a median of 164 days after discharge. Relative to neuraxial anesthesia, general anesthesia in cesarean delivery was associated with a 54% increased odds of PPD (aOR, 1.54; 95% CI, 1.21-1.95) and a 91% increased odds of suicidal ideation or self-inflicted injury (aOR, 1.91; 95% CI, 1.12-3.25). There was insufficient evidence in these data that general anesthesia was associated with anxiety disorders (aOR, 1.37; 95% CI, 0.97-1.95) or PTSD (aOR, 1.50; 95% CI, 0.50-4.47). CONCLUSIONS: General anesthesia for cesarean delivery is associated with increased odds of severe PPD requiring hospitalization, suicidal ideation, and self-inflicted injury. If confirmed, these preliminary findings underscore the need to avoid the use of general anesthesia for cesarean delivery whenever possible, and to provide mental health screening, counseling, and other follow-up services to obstetric patients exposed to general anesthesia.


Assuntos
Anestesia Geral/efeitos adversos , Cesárea , Depressão Pós-Parto/epidemiologia , Hospitalização/estatística & dados numéricos , Adulto , Anestesia por Condução , Anestesia Obstétrica , Ansiedade/psicologia , Estudos de Coortes , Feminino , Humanos , Transtornos Mentais/epidemiologia , Transtornos Mentais/etiologia , Gravidez , Pontuação de Propensão , Comportamento Autodestrutivo/epidemiologia , Comportamento Autodestrutivo/psicologia , Transtornos de Estresse Pós-Traumáticos/psicologia , Ideação Suicida , Resultado do Tratamento
11.
Epidemiol Psychiatr Sci ; 29: e170, 2020 Oct 06.
Artigo em Inglês | MEDLINE | ID: mdl-33021194

RESUMO

AIMS: Early puberty is associated with an increased risk of self-harm in adolescent females but results for males are inconsistent. This may be due to the use of subjective measures of pubertal timing, which may be biased. There is also limited evidence for the persistence of pubertal timing effects beyond adolescence, particularly in males. The primary aim of the current study was therefore to examine the association between pubertal timing and self-harm in both sexes during adolescence and young adulthood, using an objective measure of pubertal timing (age at peak height velocity; aPHV). A secondary aim was to examine whether this association differs for self-harm with v. without suicidal intent. METHODS: The sample (n = 5369, 47% male) was drawn from the Avon Longitudinal Study of Parents and Children (ALSPAC), a prospective birth cohort study. Mixed-effects growth curve models were used to calculate aPHV. Lifetime history of self-harm was self-reported at age 16 and 21 years, and associated suicidal intent was examined at age 16 years. Associations were estimated using multivariable logistic regression adjusted for a range of confounders. Missing data were imputed using Multiple Imputation by Chained Equations. RESULTS: Later aPHV was associated with a reduced risk of self-harm at 16 years in both sexes (females: adjusted per-year increase in aPHV OR 0.85; 95% CI 0.75-0.96; males: OR 0.72; 95% CI 0.59-0.88). Associations were similar for self-harm with and without suicidal intent. There was some evidence of an association by age 21 years in females (adjusted per-year increase in aPHV OR 0.91; 95% CI 0.80-1.04), although the findings did not reach conventional levels of significance. There was no evidence of an association by age 21 years in males (adjusted per-year increase in aPHV OR 0.99; 95% CI 0.74-1.31). CONCLUSIONS: Earlier developing adolescents represent a group at increased risk of self-harm. This increased risk attenuates as adolescents transition into adulthood, particularly in males. Future research is needed to identify the modifiable mechanisms underlying the association between pubertal timing and self-harm risk in order to develop interventions to reduce self-harm in adolescence.


Assuntos
Puberdade/psicologia , Comportamento Autodestrutivo/epidemiologia , Adolescente , Feminino , Humanos , Estudos Longitudinais , Masculino , Estudos Prospectivos , Fatores de Risco , Autorrelato , Comportamento Autodestrutivo/psicologia , Ideação Suicida , Inquéritos e Questionários , Adulto Jovem
12.
PLoS One ; 15(9): e0238603, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32877433

RESUMO

Given concerns about suicide or self-harm content on Instagram, we conducted a systematic scoping review of peer-reviewed English language primary studies published between 2010-2019. Only ten studies had been published. Looking into purposive samples of Instagram posts tagged with self-harm related hashtags, studies report finding self-harm or suicide content in between 9-66% of their studied posts. Studies assessing Instagram's efforts to tackle such content found they had not been very effective. Despite heterogeneity in study aims, use of terminology, samples, methods of analysis, and study outcomes, we aggregated and distinguished 'content studies' and 'user studies'. Most studies showed concern for self-harm risk, but only one examined the relationship between self-harm posts and actual self-harm behaviours offline. It found such content had negative emotional effects on some users and reported preliminary evidence of potential harmful effects in relation to self-harm related behaviours offline, although causal effects cannot be claimed. At the same time, some benefits for those who engage with self-harm content online have been suggested. More research directly interviewing Instagram users to understand this phenomenon from their perspective is required. Finally, some ethical issues are discussed.


Assuntos
Comportamento Autodestrutivo/psicologia , Mídias Sociais , Suicídio/psicologia , Humanos , Adulto Jovem
13.
Rev. psiquiatr. infanto-juv ; 37(3): 29-34, jul.-sept. 2020.
Artigo em Espanhol | IBECS | ID: ibc-197400

RESUMO

A pesar del conocimiento que tenemos en la actualidad de la amplia variedad de sintomatología y fenotipos de pacientes que engloban los Trastornos del Espectro Autista, algunos de estos fenotipos siguen sin estar claramente descritos en las clasificaciones psicopatológicas. Se propone un caso clínico de una paciente adolescente que consulta por sintomatología depresiva, descubriéndose tras la evaluación y durante la evolución un Trastorno del Espectro Autista subyacente que había pasado desapercibido


Despite current knowledge about the wide variety of symptoms and phenotypes of patients that meet criteria for Autism Spectrum Disorder, some of these phenotypes are still not clearly described in psychopathological classifications. A clinical case of a teenage patient who consults for depressive symptoms is proposed. After the evaluation, an underlying Autism Spectrum Disorder that had gone unnoticed was discovered


Assuntos
Humanos , Feminino , Adolescente , Transtorno do Espectro Autista/diagnóstico , Transtorno do Espectro Autista/psicologia , Depressão/diagnóstico , Depressão/psicologia , Comportamento Estereotipado , Comportamento Autodestrutivo/diagnóstico , Comportamento Autodestrutivo/psicologia , Comportamento Social
14.
PLoS Med ; 17(8): e1003235, 2020 08.
Artigo em Inglês | MEDLINE | ID: mdl-32760068

RESUMO

BACKGROUND: Temporal patterns in the frequency and characteristics of self-harm episodes across the Australian asylum seeker population may have implications for self-harm prevention and public health policy. The aim of this study was to examine how the distribution of self-harm episodes and method(s) of self-harm used across the Australian asylum seeker population vary according to the 24-hour cycle, day, and month, and to establish a basis for further research. METHODS AND FINDINGS: We conducted an observational study of all 949 self-harm incidents reported across the Australian asylum seeker population (representing a monthly average of 28,992 adults) between 1 August 2014 and 31 July 2015, obtained by Freedom of Information (FOI) from the Department of Immigration. Time of self-harm, day, and month of occurrence were investigated across all five Australian asylum seeker populations (i.e., community-based arrangements, community detention, onshore immigration detention, offshore immigration detention [Nauru], and offshore immigration detention [Manus Island]). Significant variations in distributions over the 24-hour cycle were observed by processing arrangements. Compared with the average distribution across all other processing arrangements, self-harm more commonly occurred among community-based asylum seekers (36.3%) between 12:00 AM and 3:59 AM (p < 0.001), in asylum seekers on Manus Island (36.4%) between 4:00 PM and 7:59 PM (p = 0.02), and among asylum seekers in onshore detention (20.4%) between 8:00 PM and 11:59 PM (p < 0.001). Compared with the average distribution across all other methods, self-poisoning (by medication) (25%) was significantly more likely to occur between 12:00 AM and 3:59 AM (p = 0.009), and self-battery (42%) between 8:00 AM and 11:59 AM (p < 0.001). The highest and lowest monthly self-harm episode rates for the whole asylum seeker population were in August (2014) (5 episodes per 1,000 asylum seekers; 95% confidence interval [CI] 1-11) and in both January and February (2015) (2.1 episodes per 1,000 asylum seekers; 95% CI 0.6-7.2), respectively; however, the overlapping CIs indicate no statistically significant differences across the months. When examining monthly trends by processing arrangements, we observed that self-harm was significantly more likely to occur in August (2014) than other months of the year among asylum seekers in onshore detention (19%) (p < 0.001), in January (2015) on Manus Island (18%) (p = 0.002), and in October (2014) on Nauru (15%) (p < 0.001). The main study limitations were that we could not investigate certain characteristics associated with self-harm (e.g., gender, country of origin), as the Department of Immigration did not routinely collect such data. There was also the potential risk of making a type 1 error, given the exploratory nature of the comparisons we undertook; we minimised this by lowering our significance threshold from 0.05 to 0.01. CONCLUSIONS: Self-harm in the Australian asylum seeker population was found to vary according to time of day and month of the year, by processing arrangements. A series of procedure-related and detention-related factors were observed to be associated with the temporal variations in self-harm. These findings should form the basis for further investigation into temporal variations in self-harm among asylum seekers, which may in turn lead to effective self-harm prevention strategies.


Assuntos
Ritmo Circadiano , Vigilância da População , Refugiados/psicologia , Estações do Ano , Comportamento Autodestrutivo/epidemiologia , Comportamento Autodestrutivo/psicologia , Adulto , Austrália/epidemiologia , Ritmo Circadiano/fisiologia , Feminino , Humanos , Masculino , Vigilância da População/métodos , Comportamento Autodestrutivo/diagnóstico , Fatores de Tempo , Adulto Jovem
15.
Artigo em Inglês | MEDLINE | ID: mdl-32854234

RESUMO

BACKGROUND: The incidence of hospital-presenting self-harm peaks among young people, who most often engage in intentional drug overdose (IDO). The risk of self-harm repetition is high among young people and switching methods between self-harm episodes is common. However, little is known about their patterns of repetition and switching following IDO. This study aimed to investigate repeat self-harm and method-switching following hospital-presenting IDO among young people. METHODS: Data from the National Self-Harm Registry Ireland on hospital-presenting self-harm by individuals aged 10-24 years during 2009-2018 were examined. Cox proportional hazards regression models with associated hazard ratios (HRs), survival curves and Poisson regression models with risk ratios (RRs), were used to examine risk factors for repetition and method-switching. RESULTS: During 2009-2018, 16,800 young people presented following IDO. Within 12 months, 2136 young people repeated self-harm. Factors associated with repetition included being male (HR = 1.13, 95% CI: 1.03-1.24), aged 10-17 years (HR = 1.29, 95% CI: 1.18-1.41), consuming ≥ 50 tablets (HR = 1.27, 95% CI: 1.07-1.49) and taking benzodiazepines (HR = 1.67, 95% CI: 1.40-1.98) or antidepressants (HR = 1.36, 95% CI: 1.18-1.56). The cumulative risk for switching method was 2.4% (95% CI: 2.2-2.7). Method-switching was most likely to occur for males (RR = 1.36; 95% CI: 1.09-1.69) and for those who took illegal drugs (RR = 1.63; 95% CI: 1.19-2.25). CONCLUSION: Young males are at increased risk of repeat self-harm and method-switching following IDO and the type and quantity of drugs taken are further indicators of risk. Interventions targeting IDO among young people are needed that ensure that mental health assessments are undertaken and which address access to drugs.


Assuntos
Overdose de Drogas/epidemiologia , Comportamento Autodestrutivo/epidemiologia , Suicídio/estatística & dados numéricos , Adolescente , Criança , Overdose de Drogas/psicologia , Feminino , Humanos , Irlanda/epidemiologia , Masculino , Modelos de Riscos Proporcionais , Recidiva , Sistema de Registros , Fatores de Risco , Comportamento Autodestrutivo/psicologia , Distribuição por Sexo , Fatores Sexuais , Adulto Jovem
16.
Crim Behav Ment Health ; 30(5): 240-255, 2020 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-32715530

RESUMO

Most studies of prisoners, the nature of their offending and any related characteristics have been conducted in rich Western countries. In Nigeria, prison conditions differ in many important respects, key among them that prisoners share large communal spaces much of the time-up to 50 men sleeping in the same space as well as spending the day together. Our aim was to compare levels of impulsivity, aggression and suicide-related behaviours between prisoners in one prison in Nigeria who had committed a homicide and those who had not, allowing for socio-demographic factors. A case-control study design was employed with 102 homicide and an equal number of non-homicide offenders. Each participant was interviewed using the Abbreviated Barratt Impulsiveness Scale for impulsivity, the Modified Overt Aggression Scale for aggression, the MINI International Neuropsychiatric Interview (Module C) for suicide-related behaviours, and a questionnaire for ascertaining socio-demographic characteristics. On bivariate analysis, motor impulsivity was higher among homicide offenders (p = .014) while non-planning was higher among non-homicide offenders (p = .006), but this relationship was affected by demographic variables. Physical aggression levels did not distinguish the two groups, but homicide offenders were less likely to record property-directed and auto-aggressive behaviours (p < .05). By contrast, on average, scores for suicide-related behaviours were lower among the homicide offenders (p = .001), with non-homicide offenders showing a mean score in the high-risk category (13.25; SD, 1.25). As motor impulsivity significantly differentiated the groups, this may be an important measure to add to any risk assessment battery when there are concerns about homicidal behaviours. In this sample, history of interpersonal aggression did not distinguish the groups. People with indications of self-harm or suicide-related behaviours may be at less risk of violence to others, but care should be taken in interpreting this finding as it is not entirely consistent with other findings.


Assuntos
Agressão/psicologia , Criminosos/psicologia , Comportamento Impulsivo , Prisioneiros/psicologia , Comportamento Autodestrutivo/psicologia , Suicídio/psicologia , Adulto , Estudos de Casos e Controles , Homicídio , Humanos , Masculino , Pessoa de Meia-Idade , Nigéria , Escalas de Graduação Psiquiátrica , Inquéritos e Questionários , Violência/psicologia
17.
Br J Psychiatry ; 217(4): 543-546, 2020 10.
Artigo em Inglês | MEDLINE | ID: mdl-32654678

RESUMO

This study explored patterns of abuse, self-harm and thoughts of suicide/self-harm in the UK during the first month of the COVID-19 pandemic using data from the COVID-19 Social Study (n=44 775), a non-probability sample weighted to population proportions. The reported frequency of abuse, self-harm and thoughts of suicide/self-harm was higher among women, Black, Asian and minority ethnic (BAME) groups and people experiencing socioeconomic disadvantage, unemployment, disability, chronic physical illnesses, mental disorders and COVID-19 diagnosis. Psychiatric medications were the most common type of support being used, but fewer than half of those affected were accessing formal or informal support.


Assuntos
Infecções por Coronavirus , Violência Doméstica , Transtornos Mentais , Pandemias , Pneumonia Viral , Comportamento Autodestrutivo , Suicídio , Adulto , Betacoronavirus , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/prevenção & controle , Infecções por Coronavirus/psicologia , Violência Doméstica/prevenção & controle , Violência Doméstica/psicologia , Violência Doméstica/estatística & dados numéricos , Feminino , Humanos , Estudos Longitudinais , Masculino , Transtornos Mentais/epidemiologia , Transtornos Mentais/virologia , Serviços de Saúde Mental , Pessoa de Meia-Idade , Pandemias/prevenção & controle , Pneumonia Viral/epidemiologia , Pneumonia Viral/prevenção & controle , Pneumonia Viral/psicologia , Prevalência , Sistemas de Apoio Psicossocial , Medição de Risco , Fatores de Risco , Comportamento Autodestrutivo/epidemiologia , Comportamento Autodestrutivo/prevenção & controle , Comportamento Autodestrutivo/psicologia , Isolamento Social/psicologia , Ideação Suicida , Suicídio/prevenção & controle , Suicídio/psicologia , Suicídio/estatística & dados numéricos , Reino Unido/epidemiologia
19.
Yonsei Med J ; 61(7): 614-622, 2020 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-32608205

RESUMO

PURPOSE: Emergency department (ED) is a common treatment setting for adolescents with clinically serious self-harm. Here, we investigated the clinical characteristics and trends of adolescents with self-harm who visited the ED in one Korean university hospital. We also compared patients with a single ED visit to those with multiple ED visits to identify the risk factor of repeated visits. MATERIALS AND METHODS: We retrospectively identified patients aged 12 to 18 years who presented to ED for self-harm from January 2015 to December 2019, based on electronic medical records. Self-harm included all thoughts and behaviors indicating intents to harm or hurt oneself, regardless of the degree of such attempt. RESULTS: A total of 168 individuals (male:female=31:137; average 15.99±1.64 years) presented to ED following 304 episodes (45 and 259 episodes in males and females, respectively). The number of episodes steeply increased between 2016 and 2019, and the overall number during the study showed an increasing trend (p=0.043). Repeated ED visitors with self-harm showed more history of psychiatric treatment/admission (58.3% vs. 85.4%, p=0.002; 14.2% vs. 43.9%, p<0.001), history of child abuse (32.3% vs. 53.7%, p=0.013), and familial psychiatric history (13.4% vs. 31.7%, p=0.008) compared to those with a single visit. CONCLUSION: Among Korean adolescents, the number of ED visits and repetition of ED visits for self-harm is on the rise. For adolescents presenting to ED with self-harm, the history of psychiatric treatment/admission, child abuse, and familial psychiatric history should be properly obtained to identify the risk for multiple ED visits.


Assuntos
Comportamento do Adolescente/psicologia , Serviço Hospitalar de Emergência/estatística & dados numéricos , Comportamento Autodestrutivo/epidemiologia , Adolescente , Adulto , Feminino , Hospitalização/estatística & dados numéricos , Hospitalização/tendências , Humanos , Masculino , República da Coreia/epidemiologia , Estudos Retrospectivos , Fatores de Risco , Comportamento Autodestrutivo/psicologia , Adulto Jovem
20.
Lancet Psychiatry ; 7(8): 682-691, 2020 08.
Artigo em Inglês | MEDLINE | ID: mdl-32711709

RESUMO

BACKGROUND: Self-harm is a leading cause of morbidity in prisoners. Although a wide range of risk factors for self-harm in prisoners has been identified, the strength and consistency of effect sizes is uncertain. We aimed to synthesise evidence and assess the risk factors associated with self-harm inside prison. METHODS: In this systematic review and meta-analysis, we searched four electronic databases (PubMed, Embase, Web of Science, and PsycINFO) for observational studies on risk factors for self-harm in prisoners published from database inception to Oct 31, 2019, supplemented through correspondence with authors of studies. We included primary studies involving adults sampled from general prison populations who self-harmed in prison and a comparison group without self-harm in prison. We excluded studies with qualitative or ecological designs, those that reported on lifetime measures of self-harm or on selected samples of prisoners, and those with a comparison group that was not appropriate or not based on general prison populations. Data were extracted from the articles and requested from study authors. Our primary outcome was the risk of self-harm for risk factors in prisoners. We pooled effect sizes as odds ratios (OR) using random effects models for each risk factor examined in at least three distinct samples. We assessed study quality on the basis of the Newcastle-Ottawa Scale and examined between-study heterogeneity. The study protocol was registered with PROSPERO, CRD42018087915. FINDINGS: We identified 35 independent studies from 20 countries comprising a total of 663 735 prisoners, of whom 24 978 (3·8%) had self-harmed in prison. Across the 40 risk factors examined, the strongest associations with self-harm in prison were found for suicide-related antecedents, including current or recent suicidal ideation (OR 13·8, 95% CI 8·6-22·1; I2=49%), lifetime history of suicidal ideation (8·9, 6·1-13·0; I2=56%), and previous self-harm (6·6, 5·3-8·3; I2=55%). Any current psychiatric diagnosis was also strongly associated with self-harm (8·1, 7·0-9·4; I2=0%), particularly major depression (9·3, 2·9-29·5; I2=91%) and borderline personality disorder (9·2, 3·7-22·5; I2=81%). Prison-specific environmental risk factors for self-harm included solitary confinement (5·6, 2·7-11·6; I2=98%), disciplinary infractions (3·5, 1·2-9·7; I2=99%), and experiencing sexual or physical victimisation while in prison (3·2, 2·1-4·8; I2=44%). Sociodemographic (OR range 1·5-2·5) and criminological (1·8-2·3) factors were only modestly associated with self-harm in prison. We did not find clear evidence of publication bias. INTERPRETATION: The wide range of risk factors across clinical and custody-related domains underscores the need for a comprehensive, prison-wide approach towards preventing self-harm in prison. This approach should incorporate both population and targeted strategies, with multiagency collaboration between the services for mental health, social care, and criminal justice having a key role. FUNDING: Wellcome Trust.


Assuntos
Prisioneiros/psicologia , Comportamento Autodestrutivo/psicologia , Tentativa de Suicídio/prevenção & controle , Transtorno da Personalidade Borderline/psicologia , Estudos de Casos e Controles , Vítimas de Crime/psicologia , Direito Penal/organização & administração , Transtorno Depressivo Maior/psicologia , Estudos de Avaliação como Assunto , Feminino , Humanos , Masculino , Transtornos Mentais/epidemiologia , Saúde Mental/normas , Estudos Observacionais como Assunto , Prisioneiros/estatística & dados numéricos , Fatores de Risco , Comportamento Autodestrutivo/mortalidade , Ideação Suicida , Tentativa de Suicídio/estatística & dados numéricos
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