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Deliberate self-harm: a comparison of first-time cases and cases with a prior history

Published online by Cambridge University Press:  13 June 2014

Kamal Gupta ,
Kandiah Sivakumar  and
Nigel Smeeton
Kamal Gupta
Affiliation:
Maidstone Hospital, (Currently Senior Registrar, UMDS, Guy's and St Thomas's Hospitals and the South East Thames Regional Health Authority.)
Kandiah Sivakumar
Affiliation:
Maidstone Hospital, Psychiatric Wing, Hermitage Lane, Maidstone, Kent ME16 9QQ, England
Nigel Smeeton
Affiliation:
UMDS, Guy's Campus, Department of Public Health Medicine, London Bridge, London, SEI 9RT, England
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Abstract

Objective: Eighty one patients admitted following deliberate self-harm were assessed using a semi-structured interview. The aim of the study was to compare clinical and social profiles of the 42 patients who had committed self harm for the first time with those of the 39 who had committed self harm in the past.

Method: The patients were assessed jointly by a psychiatrist and either a community psychiatric nurse or a social worker. A description of past suicidal behaviour, socio demographic information, medical and psychiatric history were recorded. Suicide intent was assessed both from the clinical interview and rated objectively using Pierce's suicide intent scale. Psychiatric diagnoses were made using the ICD 9 classification.

Results: The entire group had experienced difficulties in sustaining relationships. This problem was significantly more widespread in repeaters with increased use of physical violence in their relationship. More patients with a previous history claimed to have death wishes at the time of self harm, and asserted that they would harm themselves again compared with patients without a previous history. Clinical predictions regarding future self harming behaviour were in line with the patient's stated intentions.

Conclusion: The persistent desire to commit self harm and more widespread relational difficulties amongst the patients with a previous history suggests a need for different treatment strategies and outcome measures for the two groups.

Keywords

Deliberate self-harmFirst-everFirst episodesRepeaters
Type
Original Papers
Information
Irish Journal of Psychological Medicine , Volume 12 , Issue 4 , December 1995 , pp. 131 - 134
Copyright
Copyright © Cambridge University Press 1995

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