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[Risk factors of near-fatal deliberate self-harm behavior in self-cutting patients: a three-year follow-up study at a psychiatric clinic].
Seishin Shinkeigaku Zasshi 2008; 110(6):475-87SS

Abstract

Non-fatal self-injurious behavior such as cutting oneself is often performed without suicidal intent to cope with emotional distress, although it is well-known to have a close association with future suicidal behavior. However, it is unclear what kinds of clinical features are presented by such self-injuring patients with a higher suicidal tendency. In the present study, we conducted a three-year follow-up study of female self-injuring patients to examine the risk factors of "near-fatal" deliberate self-harm behavior (DSH). The subjects were 81 female outpatients who had cut themselves at least once, and who had consulted a psychiatric clinic from June 2004 to July 2004. Initial assessments included traumatic life events, clinical features of self-cutting, histories of self-poisoning, alcohol abuse (Alcohol Use Disorders Identification Test: AUDIT), impulsivity (Barratt Impulsiveness Scale, 11th version: BIS-11), symptoms of bulimia nervosa (Bulimia Investigatory Test, Edinburgh: BITE), dissociation (Adolescent Dissociative Experience Scale: ADES), Global Assessment of Functioning (GAF) score, and axis I diagnosis of DSM-IV (Diagnostic and Statistical Manual, 4th version). After three years, we investigated whether the subjects had committed fatal DSH during the follow-up term. We obtained information on fatal DSH from 67 subjects during the follow-up term. Fifteen of the 67 (22.4%) had committed near-fatal DSH at least once, and one subject committed suicide by fatal DSH. Monovariate analysis revealed that in the initial assessment, the subjects with near-fatal DSH episodes more frequently reported a history of victimization by rape in adulthood and a history of OTC (over-the-counter) drug self-poisoning, and had higher scores on the BITE and AUDIT than those without near-fatal DSH episodes. Further, multivariate analysis demonstrated that only the BITE score was a significant factor in predicting future near-fatal DSH. In conclusion, symptoms of bulimia nervosa may have important clinical implications. The BITE may be a useful tool to assess future suicidal behavior in female self-cutting patients.

Authors+Show Affiliations

National Institute of Mental Health, National Center of Neurology and Psychiatry.No affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

English Abstract
Journal Article

Language

jpn

PubMed ID

18717158

Citation

Matsumoto, Toshihiko, et al. "[Risk Factors of Near-fatal Deliberate Self-harm Behavior in Self-cutting Patients: a Three-year Follow-up Study at a Psychiatric Clinic]." Seishin Shinkeigaku Zasshi = Psychiatria Et Neurologia Japonica, vol. 110, no. 6, 2008, pp. 475-87.
Matsumoto T, Azekawa T, Itami A, et al. [Risk factors of near-fatal deliberate self-harm behavior in self-cutting patients: a three-year follow-up study at a psychiatric clinic]. Seishin Shinkeigaku Zasshi. 2008;110(6):475-87.
Matsumoto, T., Azekawa, T., Itami, A., & Takeshima, T. (2008). [Risk factors of near-fatal deliberate self-harm behavior in self-cutting patients: a three-year follow-up study at a psychiatric clinic]. Seishin Shinkeigaku Zasshi = Psychiatria Et Neurologia Japonica, 110(6), pp. 475-87.
Matsumoto T, et al. [Risk Factors of Near-fatal Deliberate Self-harm Behavior in Self-cutting Patients: a Three-year Follow-up Study at a Psychiatric Clinic]. Seishin Shinkeigaku Zasshi. 2008;110(6):475-87. PubMed PMID: 18717158.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - [Risk factors of near-fatal deliberate self-harm behavior in self-cutting patients: a three-year follow-up study at a psychiatric clinic]. AU - Matsumoto,Toshihiko, AU - Azekawa,Takaharu, AU - Itami,Akira, AU - Takeshima,Tadashi, PY - 2008/8/23/pubmed PY - 2008/10/3/medline PY - 2008/8/23/entrez SP - 475 EP - 87 JF - Seishin shinkeigaku zasshi = Psychiatria et neurologia Japonica JO - Seishin Shinkeigaku Zasshi VL - 110 IS - 6 N2 - Non-fatal self-injurious behavior such as cutting oneself is often performed without suicidal intent to cope with emotional distress, although it is well-known to have a close association with future suicidal behavior. However, it is unclear what kinds of clinical features are presented by such self-injuring patients with a higher suicidal tendency. In the present study, we conducted a three-year follow-up study of female self-injuring patients to examine the risk factors of "near-fatal" deliberate self-harm behavior (DSH). The subjects were 81 female outpatients who had cut themselves at least once, and who had consulted a psychiatric clinic from June 2004 to July 2004. Initial assessments included traumatic life events, clinical features of self-cutting, histories of self-poisoning, alcohol abuse (Alcohol Use Disorders Identification Test: AUDIT), impulsivity (Barratt Impulsiveness Scale, 11th version: BIS-11), symptoms of bulimia nervosa (Bulimia Investigatory Test, Edinburgh: BITE), dissociation (Adolescent Dissociative Experience Scale: ADES), Global Assessment of Functioning (GAF) score, and axis I diagnosis of DSM-IV (Diagnostic and Statistical Manual, 4th version). After three years, we investigated whether the subjects had committed fatal DSH during the follow-up term. We obtained information on fatal DSH from 67 subjects during the follow-up term. Fifteen of the 67 (22.4%) had committed near-fatal DSH at least once, and one subject committed suicide by fatal DSH. Monovariate analysis revealed that in the initial assessment, the subjects with near-fatal DSH episodes more frequently reported a history of victimization by rape in adulthood and a history of OTC (over-the-counter) drug self-poisoning, and had higher scores on the BITE and AUDIT than those without near-fatal DSH episodes. Further, multivariate analysis demonstrated that only the BITE score was a significant factor in predicting future near-fatal DSH. In conclusion, symptoms of bulimia nervosa may have important clinical implications. The BITE may be a useful tool to assess future suicidal behavior in female self-cutting patients. SN - 0033-2658 UR - https://www.unboundmedicine.com/medline/citation/18717158/[Risk_factors_of_near_fatal_deliberate_self_harm_behavior_in_self_cutting_patients:_a_three_year_follow_up_study_at_a_psychiatric_clinic]_ L2 - https://medlineplus.gov/selfharm.html DB - PRIME DP - Unbound Medicine ER -