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Clinical characteristics of patients with self harming behaviour in a low secure mental health unit

Published online by Cambridge University Press:  27 November 2009

M Dominic Beer ,
Anandamurugan Muthukumaraswamy ,
Al Aditya Khan  and
Mohammad Arif Musabbir
M Dominic Beer*
Affiliation:
Consultant Psychiatrist in Challenging Behaviour and Intensive Care Psychiatry, Oxleas NHS Foundation Trust and Senior Lecturer, Division of Psychological Medicine, Institute of Psychiatry, London, UK
Anandamurugan Muthukumaraswamy
Affiliation:
Specialist Registrar, St Thomas’ Hospital, South London and Maudsley NHS Foundation Trust, London, UK
Al Aditya Khan
Affiliation:
Speciality Registrar 4, Forensic Psychiatry, Hampshire Partnership NHS Trust, Southampton, UK
Mohammad Arif Musabbir
Affiliation:
Speciality Registrar 1, Leeds Mental Health Foundation Trust, Leeds, UK
*
Correspondence to: Dr M. D. Beer, Bracton Centre, Oxleas NHS Foundation Trust, Bracton Lane, Dartford, Kent, DA2 7AF, UK. E-mail: [email protected]
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Abstract

Aims: To describe the methods of self harm incidents in a low secure unit population and to identify and compare the clinical characteristics of patients displaying inpatient self harming behaviours with those who do not display such behaviours.

Method: A retrospective case control study was conducted. Details about the inpatient self harming incidents were collected from an incident database. Clinical characteristics of those who displayed inpatient self harming incidents (cases) and those who did not display such behaviours (controls) were compared. Analysis was performed to establish statistical significance on the observed differences.

Results: 80 admissions resulted from 78 patients during a 6½ year period. 21% of patients presented with inpatient self harming behaviours. 57% of the incidents were caused by 13% of patients. Clinical characteristics such as white ethnic background, histories of self harm, physical or sexual abuse, childhood conduct problems and lack of educational qualifications and having a diagnosis of schizoaffective disorder were more likely to be associated with inpatients self harming in low secure settings. Sexually inappropriate behaviours and a diagnosis of schizophrenia were less likely to be associated with this group.

Conclusion: The majority of self harm incidents are caused by a minority of patients. Most of the clinical characteristics associated with the low secure inpatient self harming patients are similar to those observed in other psychiatric inpatient settings.

Keywords

Self harminpatient self harmdeliberate self harmlow securechallenging behaviour
Type
Original Paper
Information
Journal of Psychiatric Intensive Care , Volume 6 , Issue 1 , June 2010 , pp. 15 - 21
Copyright
Copyright © NAPICU 2009

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References

Beer, M.D., Khan, A.A. and Ratnajothy, K. (2006) The effect of clozapine on adverse incidents in a low secure challenging behaviour unit. Journal of Psychiatric Intensive Care. 2(2): 65–70.CrossRefGoogle Scholar
Gournay, K. and Bowers, L. (2000) Suicide and self-harm in in-patient psychiatric units: A study of nursing issues in 31 cases. Journal of Advanced Nursing. 32(1): 124–131.CrossRefGoogle ScholarPubMed
Haw, C., Hawton, K., Sutton, L., Sinclair, J. and Deeks, J. (2005) Schizophrenia and deliberate self-harm: A systematic review of risk factors. Suicide and Life-Threatening Behaviour. 35(1): 50–62.CrossRefGoogle ScholarPubMed
Hawton, K., Sutton, L., Haw, C., Sinclair, J. and Harriss, L. (2005) Suicide and attempted suicide in bipolar disorder: A systematic review of risk factors. Journal of Clinical Psychiatry. 66(6): 693–704.CrossRefGoogle ScholarPubMed
Hillbrand, M., Krystal, J.H., Sharpe, K.S. and Foster, H.G. (1994) Clinical predictors of self-mutilation in hospitalized forensic patients. The Journal of Nervous and Mental Disease. 182: 9–13.CrossRefGoogle ScholarPubMed
Hunt, I.M., Kapur, N., Webb, R., Robinson, J., Burns, J., Turnbull, P., Shaw, J. and Appleby, L. (2007) Suicide in current psychiatric in-patients: A case-control study. Psychological Medicine. 37(6): 831–837.CrossRefGoogle ScholarPubMed
Jacobson, R., Jackson, M. and Berelowitz, M. (1986) Self-incineration: A controlled comparison of in-patient suicide attempts, Clinical features and history of self-harm. Psychological Medicine. 16(1): 107–116.CrossRefGoogle ScholarPubMed
Johnston, A., Cooper, J., Webb, R. and Kapur, N. (2006) Individual- and area-level predictors of self-harm repetition. British Journal of Psychiatry. 189: 416–421.CrossRefGoogle ScholarPubMed
King, E., Baldwin, D. and Sinclair, J. (2001) Case-control study of 59 in-patient suicides. British Journal of Psychiatry. 178: 537–542.CrossRefGoogle ScholarPubMed
Klonsky, E.D. and Moyer, A. (2008) Childhood sexual abuse and non-suicidal self-injury: Meta-analysis. British Journal of Psychiatry. 192: 166–170.CrossRefGoogle ScholarPubMed
Mohino, J.S., Ortega-Monasterio, L., Planchat, T.L.M., Cuquerella, F.A., Talón, N.T. and Macho, V.L.J. (2004) Discriminating deliberate self-harm (DSH) in young prison inmates through personality disorder. Journal of Forensic Sciences. 49(1): 137–140.CrossRefGoogle Scholar
Morgan, H.G., Barton, J., Pottle, S., Pocock, H. and Burns-Cox, C.J. (1976) Deliberate self-harm: A follow-up study of 279 patients. British Journal of Psychiatry. 128: 361–368.CrossRefGoogle ScholarPubMed
Myers, E.D. (1982) Subsequent deliberate self-harm in patients referred to a psychiatrist: a prospective study. British Journal of Psychiatry. 140: 132–137.CrossRefGoogle ScholarPubMed
Powell, J., Geddes, J., Hawton, K., Deeks, J. and Goldacre, M. (2000) Suicide in psychiatric hospital in-patients: Risk factors and their predictive power. British Journal of Psychiatry. 176: 266–272.CrossRefGoogle ScholarPubMed
Wessely, S., Akhurst, R., Brown, I. and Moss, L. (1996) Deliberate self harm and the probation service: An overlooked health problem? Journal of Public Health Medicine. 18(2): 129–132.CrossRefGoogle ScholarPubMed
Young, M.H., Justice, J.V. and Erdberg, P. (2006) Risk of harm: Inmates who harm themselves while in prison psychiatric treatment. Journal of Forensic Sciences. 51(1): 156–162.CrossRefGoogle ScholarPubMed