Self-harm in first-episode psychosis

British Journal of Psychiatry - Tập 192 Số 3 - Trang 178-184 - 2008
Samuel B. Harvey1, Kimberlie Dean1, Craig Morgan1, Elizabeth Walsh1, Arsime Demjaha1, Paola Dazzan1, Kevin Morgan1, T A Lloyd2, Paul Fearon1, Peter B. Jones3, Robin Murray4
1Department of Psychological Medicine, Institute of Psychiatry, King’s College London
2University of Nottingham, Nottingham
3Department of Psychiatry, University of Cambridge, Cambridge
4Department of Psychological Medicine, Institute of Psychiatry, King's College London, UK

Tóm tắt

BackgroundLittle is known about self-harm occurring during the period of untreated first-episode psychosis.AimsTo establish the prevalence, nature, motivation and risk factors for self-harm occurring during the untreated phase of first-episode psychosis.MethodAs part of the æSOP (Aetiology and Ethnicity in Schizophrenia and Other Psychoses) study, episodes of self-harm were identified among all incident cases of psychosis presenting to services in south-east London and Nottingham over a 2-year period.ResultsOf the 496 participants, 56 (11.3%) had engaged in self-harm between the onset of psychotic symptoms and first presentation to services. The independent correlates of self-harm were: male gender, belonging to social class I/II, depression and a prolonged period of untreated psychosis. Increased insight was also associated with risk of self-harm.ConclusionsSelf-harm is common during the pre-treatment phase of first-episode psychosis. A unique set of fixed and malleable risk factors appear to operate in those with first-episode psychosis. Reducing treatment delay and modifying disease attitudes may be key targets for suicide prevention.

Từ khóa


Tài liệu tham khảo

10.1097/01.yco.0000191498.69281.5e

10.1111/j.1600-0447.2005.00620.x

10.1192/bjp.181.43.s98

10.1192/bjp.187.1.9

Morgan, 2006, First episode psychosis and ethnicity: initial findings from the ÆSOP study, World Psychiatry, 5

10.1017/S0033291706008774

10.1192/bjp.151.5.619

10.1017/S0264180100000904

10.1016/j.schres.2006.05.026

DeHert, 2000, The International Handbook of Suicide and Attempted Suicide

10.1521/suli.35.1.50.59260

10.1521/pedi.18.1.102.32770

1994, Schedules for Clinical Assessment in Neuropsychiatry (SCAN) – Version 2.0

Carpenter, 1978, Signs and symptoms as predictors of outcome: a report from the International Pilot Study of Schizophrenia, Am J Psychiatry, 135

10.1097/00005053-199906000-00007

10.1001/archpsyc.62.3.247

10.1001/archpsyc.63.3.250

2001, The Mental Health Policy Implementation Guide

10.1046/j.0001-690X.2003.00232.x

Wechsler, 1981, Wechsler Adult Intelligence Scale

10.1016/S0920-9964(02)00310-9

10.1136/bmj.311.7016.1325

10.1521/suli.2006.36.1.44

10.1046/j.1440-1614.2003.01209.x

10.1192/bjp.182.3.196

Nelson, 1982, National Adult Reading Test (NART) Test Manual

10.1111/j.1600-0447.1996.tb10656.x

10.1176/ajp.2006.163.5.800

Caldwell, 1992, Schizophrenia – a high-risk factor for suicide: clues to risk reduction, Suicide Life Threat Behav, 22, 10.1111/j.1943-278X.1992.tb01040.x

10.1192/bjp.183.1.40

10.1093/schbul/13.2.299

10.1093/schbul/16.4.663

Kemp, 1997, Compliance and the Therapeutic Alliance in Serious Mental Illness, 61

10.1016/S0022-3956(03)00088-8

1992, The ICD-10 Classification of Mental and Behavioural Disorders: Clinical descriptions and diagnostic guidelines

Wing, 1974, Measurement and Classification of Psychiatric Symptoms: An instruction manual for the PSE and Catego program

10.1017/S003329179900135X

Mallett, 1997, Sociodemographic Schedule

10.1016/S0272-7358(00)00070-2

10.1016/S0920-9964(02)00164-0

10.1192/bjp.162.1.65

Thông tin
Thông tin xuất bản

British Journal of Psychiatry

Tập 192 Số 3

178-184

Thông tin tác giả