Background Non-suicidal self-injury (NSSI) and aggression have been demonstrated to serve as risk factors of suicidal behaviours (SB). Non-suicidal self-injury disorder (NSSID) and Suicidal Behaviour Disorder (SBD) are among new diagnostic categories for further studies in the DSM-5 classification. Methods We recruited 196 girls (aged 15.5 ± 1.2 years) diagnosed with conduct disorder (CD). All of them were assessed with respect of non-suicidal self-injury acts, suicidal attempts, psychopathology, self-esteem and general functioning. Results Age of NSSI onset was significantly lower compared to age of first suicidal attempt. SBD was present in 50.0% of patients with NSSID and the prevalence of NSSID in individuals with SBD was estimated at 52.2%. A diagnosis of NSSID, with at least 8 days of engagement in self-injuries during the preceding year, significantly predicted the risk of SBD. This effect appeared to be independent of depressive symptomatology. Limitations Our results cannot be generalized over the whole population of individuals diagnosed with CD because of a lack of male patients, as well as individuals with the most severe and mildest forms of CD. Causal inferences cannot be established due to a cross-sectional study design. Conclusions The NSSID with at least 8 days of engagement in self-injuries during the preceding year serves as a predictor of SBD independently of the effects of depressive symptoms. Longitudinal studies are required to confirm our findings.
Non-suicidal self-injuries (NSSIs) have been identified as one of the most predictive factors of suicidal behaviours in adolescents. However, it remains unknown whether certain functions of NSSIs are associated with suicide risk, and what are the underlying mechanisms. Therefore, we aimed to investigate the association between functions of NSSIs and suicide risk in adolescents with conduct disorder (CD), which shares some common characteristics with NSSIs. Participants were 215 adolescents (155 females, 72.1%) with CD. Functions of NSSIs, depressive symptoms, the levels of impulsivity, anxiety, self-esteem and aggression were examined. There were 77 adolescents with lifetime history of NSSIs (35.8%). Among them, adolescents with lifetime history of suicide attempt were significantly more likely to report anti-dissociation and anti-suicide function of NSSIs. They had significantly higher levels of anxiety as well as significantly lower self-esteem. Higher lifetime number of NSSIs was associated with higher odds of reporting anti-dissociation and anti-suicide functions. Moreover, these two functions fully mediated the association between lifetime number of NSSIs and suicide risk after co-varying for depressive and anxiety symptoms as well as self-esteem. The present findings indicate that anti-suicide and anti-dissociation functions of NSSIs might be crucial predictors of suicide risk in adolescents with CD.
In some patients diagnosed with eating disorders the application of standard therapeutic modalities is ineffective or results in incomplete remission of symptoms. It is worth pointing out that 51–73% of patients discontinue their treatment. Therefore, there is an ongoing search for psychotherapeutic methods that would increase the effectiveness of treatment in this group of patients. One of them is psychodynamic group therapy. For adolescents, both when it comes to healthy teenagers and those meeting the criteria of psychological disorders, being in touch with their peers serves important developmental functions. Above all, it provides a chance to differentiate oneself from the family system and create a separate identity. The aim of the article is to describe our experience and work methods related to the provision of an intense, two-week-long group therapy for adolescent patients diagnosed with eating disorders. The role of pre-treatment psychotherapy consultations as well as inclusion and exclusion criteria will be discussed, as this form of therapy is directed at a selected group of patients. For several years now, group psychotherapy has been a part of outpatient treatment of patients with eating disorders at the “Neuromed” Neuropsychiatry Centre in Wrocław. The method relies on various elements such as psychoeducation and art therapy. Work techniques are reinforced by therapeutic dialogue, clarification, confrontation, and talking through the group process. The therapy is focused on activating the processes of introspection and mentalisation. The aims of group psychotherapy include gaining in-depth insights into the psychotherapeutic diagnosis, strengthening the motivation for treatment, addressing distorted body image, engaging in self-reflection, and increasing the awareness of functioning in interpersonal relationships.
The aim of the study is to present the process of diagnosis and treatment of the patients poisoned with toxic alcohols. Furthermore, the suicide risk assessment was presented. The role of supportive cure and the importance of the treatment with alcohol dehydrogenase blockade with fomepizole or ethanol hemodialysis for severe intoxicated patients were presented. The differences in the treatment of poisoning with particular toxic alcohols were presented. Moreover, the important psychological factors in the management of this group of patients were also discussed. The paper was illustrated with typical case studies of patients suffering from methanol and ethylene glycol intoxication. Conclusions: 1. The recognition of toxic alcohol poisoning remains a challenge for the clinician, because nonspecific symptoms are similar in many other conditions. 2. Proper management of the poisoned patients requires thorough analysis of many aspects: circumstances of the event, laboratory findings, response to the treatment, and the patient’s psychological problems.
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