Social and clinical risk factors for completed suicide occurring shortly after discharge from a psychiatric hospital were examined in this case-control study. Seventy-seven individuals who received "suicide" or "undetermined death" verdicts at inquest, and who had been previously discharged from psychiatric hospitals in Bradford, U.K., were compared with a control group. A history of deliberate self-harm was significantly associated with early suicides compared with both late suicides and controls. A diagnosis of mood disorder, specifically depression, and longer case-notes were also significantly associated with early suicides compared to controls. This study has implications for risk management of recently discharged psychiatric patients.
Our clinical experience that lithium is an agent used infrequently for self-poisoning was investigated. The rate at which such overdoses occurred was determined from hospital records. A retrospective case notes study then compared overdose rates in patients taking lithium versus patients on antidepressant medication. A low rate of lithium overdoses was identified, and this appeared to be due to patients on lithium rarely taking overdoses rather than their choice of agent.
This study compared children and adolescents who had deliberately selfharmed (DSH) with those who had not using data routinely collected during assessment at a Child and Adolescent Mental Health Service (CAMHS). The DSH group consisted of 64 boys and 194 girls aged between 7 to 18 years. The control group consisted of 175 boys and 181 girls aged between 11 and 18.As in previous studies, there was a substantially higher proportion of girls who self-harmed or who had depressive symptoms when compared to boys. The study investigated the effectiveness of HoNOSCA as an assessment tool for DSH and compared it with other measures of seriousness of self-harm (BDI, PATHOS, clinician-based risk rating or previous episodes of self-harm). Comparisons of HoNOSCA-rated 'self injury' with other assessment tools showed advantages of the latter in detecting individuals at risk.The study also investigated whether DSH was linked to changes in family living and explored trigger or risk factors. The HoNOSCA item 'Problems with family life and relationships' was linked to self-harm as expected. However, there were no substantial differences between the groups for measures of family living.Analyses of risk factors showed background issues concerning breakdown of relationships and self esteem were relevant to DSH.
120 children referred to a child and adolescent psychiatric service in a university clinic were studied with the aim of deriving predictors for grouped ICD10 diagnoses using the CBCL Cross-Informant-Syndromes (CISs). CIS7 (Delinquent Behaviour) and CIS8 (Aggressive Behaviour) were shown to significantly separate Disruptive Behaviour Disorders from all other disorders. As cross-validation, a separate clinical sample of 118 children from a similar service in another part of the country was used to see to what extent the CIS predictors from the first sample held up in the second sample. Positive and Negative Predictive Powers, all corrected for chance, confirmed that the Disruptive Behaviour Disorder group could be usefully separated from all other disorders using the Delinquent Behaviour and the Aggressive Behaviour Cross-Informant Syndrome scores. There was no good evidence that Emotional (Anxiety-Mood) Disturbance could be usefully separated in the same way using the Anxious-Depressed Syndrome (CIS3) or any other syndrome. Discriminant Function Analysis showed that there was no significant improvement in prediction when more elaborate linear combinations of the syndromes were used.
Total loss of colour vision which is acquired is rare and is usually organic. Standard ophthalmological textbooks do not mention psychogenic causes. One case, reported here, highlights the existence of non-organic achromatopsia (loss of colour vision) in children and the importance of maintaining links between child mental-health workers and other disciplines such as ophthalmologists to establish appropriate investigation and management.
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