Northampton Electronic Collection of Theses and Research

Psychiatric disorders in patients presenting to hospital following self-harm: a systematic review

Hawton, K., Saunders, K., Topiwala, A. and Haw, C. (2013) Psychiatric disorders in patients presenting to hospital following self-harm: a systematic review. Journal of Affective Disorders. 151(3), pp. 821-830. 0165-0327.

Item Type: Article
Abstract: Background Psychiatric disorders occur in approximately 90% of individuals dying by suicide. The prevalence of psychiatric disorders in people who engage in non-fatal self-harm has received less attention. Method Systematic review using electronic databases (Embase, PsychINFO and Medline) for English language publications of studies in which psychiatric disorders have been assessed using research or clinical diagnostic schedules in self-harm patients of all ages presenting to general hospitals, followed by meta-analyses using random effects methods. Results A total of 50 studies from 24 countries were identified. Psychiatric (Axis I) disorders were identified in 83.9% (95% CI 74.7–91.3%) of adults and 81.2% (95% CI 60.9–95.5%) of adolescents and young persons. The most frequent disorders were depression, anxiety and alcohol misuse, and additionally attention deficit hyperactivity disorder (ADHD) and conduct disorder in younger patients. Personality (Axis II) disorders were found in 27.5% (95% CI 17.6–38.7%) of adult patients. Psychiatric disorders were somewhat more common in patients in Western (89.6%, 95% CI 83.0–94.7%) than non-Western countries (70.6%, 95% CI 50.1–87.6%). Limitations Heterogeneity between study results was generally high. There were differences between studies in identification of study participants and diagnostic procedures. Conclusions Most self-harm patients have psychiatric disorders, as found in people dying by suicide. Depression and anxiety disorders are particularly common, together with ADHD and conduct disorder in adolescents. Psychosocial assessment and aftercare of self-harm patients should include careful screening for such disorders and appropriate therapeutic interventions. Longitudinal studies of the progress of these disorders are required.
Uncontrolled Keywords: Attempted suicide, personality disorders, psychiatric disorders, self-harm, systematic review
Subjects: R Medicine > RC Internal medicine > RC435 Psychiatry > RC530 Neuroses > RC537 Depression
R Medicine > RC Internal medicine > RC435 Psychiatry > RC554 Personality disorders. Behavior problems
Creators: Hawton, Keith, Saunders, Kate, Topiwala, Anya and Haw, Camilla
Publisher: Elsevier
Northamptonshire and East Midlands: Health
Faculties, Divisions and Institutes: University Faculties, Divisions and Research Centres - OLD > Faculty of Health & Society > Mental Health and Learning Disability
Date: December 2013
Date Type: Presentation
Page Range: pp. 821-830
Journal or Publication Title: Journal of Affective Disorders
Volume: 151
Number: 3
Language: English
DOI: https://doi.org/10.1016/j.jad.2013.08.020
ISSN: 0165-0327
Status: Published / Disseminated
URI: http://nectar.northampton.ac.uk/id/eprint/6481

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