Adolescents Admitted For Self Harm At Risk For Further Self Harming Behavior

MedicalResearch.com Interview with:

Dr Annie Herbert, PhD Department of Behavioural Science and Health, Institute of Epidemiology and Healthcare University College London London  UK

Dr. Herbert

Dr Annie Herbert, PhD
Department of Behavioural Science and Health, Institute of Epidemiology and Healthcare
University College London
London  UK 

MedicalResearch.com: What is the background for this study?

Response: 1 in 25 adolescents (i.e. one in every classroom) will be admitted to hospital as an emergency with injuries related self-harm, drug or alcohol misuse, or violence. Currently, the guidelines for how these adolescents are managed differ greatly depending on the type of injury they come in with (whether through self-harm, drug or alcohol misuse, or violence).

MedicalResearch.com: What are the main findings?

Response: In our study, we found that adolescents admitted with any of these injuries were at an increased risk of suicide and of drug or alcohol related death in the ten years after leaving hospital, compared to other admitted adolescents.While the overall risk is relatively low—for example, 2–3 girls out of 1000 and 7 boys out of 1000 who are admitted as an emergency to hospital with drug or alcohol related injuries die from suicide within 10 years—the rates are 5–6 times higher than among adolescents admitted to hospital following an accident.

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Deliberate Self-harm Associated With Violent Criminality

MedicalResearch.com Interview with:

Hanna Sahlin MSc, Lic psychologist, Lic psychotherapist Specialist in clinical psychology PhD-student Departement of Clinical Neuroscience Karolinska Institutet National Self-harm project Centre for Psychiatry Research, CPF Stockholm, Sweden

Hanna Sahlin

Hanna Sahlin
MSc, Lic psychologist, Lic psychotherapist
Specialist in clinical psychology
PhD-student
Departement of Clinical Neuroscience
Karolinska Institutet
National Self-harm project
Centre for Psychiatry Research, CPF
Stockholm, Sweden

What is the background for this study? What are the main findings?

Response: This study is the result of wanting to find a more conclusive answer to whether individuals who engage in non-fatal deliberate self-harm are more prone to aggression towards others. There has long been a debate on whether aggression to oneself and aggression towards others co-occur, but the studies that have been conducted thus far have been on smaller samples or with clinical or forensic cohorts. Also, the studies have had great variability regarding the definition of both “deliberate self-harm” and “violence”. Thus, it has been difficult to establish an ”overall” effect size for this association, or to draw firmer conclusions on how and if this association plays out in the general population.

We had the opportunity to study this association in several large nationwide population-based registries including all Swedish citizens, and with high specificity regarding the ingoing variables of interest – i.e., non-fatal deliberate self-harm (as registered in the National Patient Register) and violent crime convictions (as registered in the National Crime Register).

We found a five times increased crude risk (hazard) of being convicted of a violent crime if one had received self-harm associated clinical care, and vice-versa, that there was an equally increased risk of self-harm if one had been convicted of a violent crime. After controlling for relevant psychiatric comorbidities and socio-economic status, an almost doubled risk of violent crime conviction remained among self-harming men and women compared to individuals not exposed to self-harm. It is important to notice that our study did not find any evidence suggesting that self-harm behaviours cause violent criminality. Therefore, we conclude that the engagement in violence towards oneself and towards others share an underlying vulnerability to impulsive and aggressive behaviours.

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