p.2
Risk Factors for Self-Harm
What are some psychosocial stressors that may lead to self-harm?
Unemployment, relationship break-ups, or the death of a significant individual.
p.4
Management Strategies for Self-Harm
What factors determine the management of self-harm?
History, mental state examination, collateral history, and investigations.
p.2
Assessment of Self-Harm and Suicide Risk
What past history should be assessed in individuals who self-harm?
Past psychiatric illness, history of self-harm, and previous psychiatric medications.
p.1
Demographics and Statistics of Self-Harm in Ireland
How does gender influence self-harm rates?
Females are more likely to self-harm than males, but the ratio is approximately 1:1 in individuals over 50.
p.2
Assessment of Self-Harm and Suicide Risk
What should be evaluated after a self-harm act?
Help-seeking behavior, desire for further self-harm, and feelings of regret.
p.3
Assessment of Self-Harm and Suicide Risk
What should be evaluated regarding current medication?
Compliance with prescribed medication.
p.4
Factors Influencing Suicidal Intent
What factors after self-harm are associated with increased suicidal intent?
Not seeking help, regret that the episode did not result in death, continued desire to die, access to means for re-attempt, and mental illness.
p.3
Assessment of Self-Harm and Suicide Risk
What social factors are considered in the assessment of self-harm?
Collateral history and documentation from previous psychiatric services.
p.1
Demographics and Statistics of Self-Harm in Ireland
Which demographic has the peak rates of self-harm presentations in Ireland?
Young people, specifically 15-19 year old females and 25-29 year old males.
p.2
Mental Health Conditions Associated with Self-Harm
What is included in the cognitive-behavioral cluster of depressive symptoms?
Reduced concentration, feelings of low self-worth, hopelessness, and recurrent thoughts of death.
p.4
Factors Influencing Suicidal Intent
What factors during self-harm indicate increased suicidal intent?
Perceived lethality of the episode, use of dangerous methods, being alone, unlikely intervention, and precautions to avoid discovery.
p.3
Assessment of Self-Harm and Suicide Risk
What psychological assessments are used in self-harm evaluation?
Suicide risk rating scales and depression rating scales.
p.3
Assessment of Self-Harm and Suicide Risk
What past medical history is relevant in assessing self-harm?
History of significant medical illness and/or head injury.
p.4
Management Strategies for Self-Harm
What social interventions can assist individuals who self-harm?
Alcohol/substance misuse counseling, social work input for employment and housing, occupational therapy, social skills training, and support groups.
p.3
Assessment of Self-Harm and Suicide Risk
What biological investigations are recommended for self-harm assessment?
Blood tests, ECG, EEG, CT/MRI brain scan, and urine drug screen.
p.3
Risk Factors for Self-Harm
What personal history factors are considered in self-harm assessment?
Occupational history, relationship history, and psychosocial history.
p.1
Risk Factors for Self-Harm
What role does alcohol play in self-harm presentations?
Alcohol is involved in approximately one third of self-harm presentations.
p.4
Management Strategies for Self-Harm
What psychological therapies are used in the management of self-harm?
Risk management, psychoeducation, supportive therapy, cognitive behavioral therapy, behavioral therapy, dialectical behavioral therapy, interpersonal therapy, and family and couples therapy.
p.3
Risk Factors for Self-Harm
What factors should be considered in risk assessment for self-harm?
Methods and frequency of self-harm, suicidal intent, depressive symptoms, and personal context.
p.2
Assessment of Self-Harm and Suicide Risk
What features should be assessed during the self-harm act?
Quantity of substances consumed, associated use of alcohol or illicit substances, and expectations of self-harm.
p.1
Definition and Overview of Self-Harm
What is self-harm defined as?
Intentional self-poisoning or self-injury, irrespective of motivation, often associated with alcohol.
p.3
Assessment of Self-Harm and Suicide Risk
What is collateral history in the context of self-harm?
Information from others about the patient's self-harm episode and their state afterward.
p.2
Assessment of Self-Harm and Suicide Risk
What does the presence of a suicide note indicate?
It may suggest a higher degree of planning and intent regarding self-harm.
p.2
Mental Health Conditions Associated with Self-Harm
What are the presenting symptoms suggestive of depression?
Depressed mood, diminished interest in activities, cognitive issues, and neurovegetative symptoms.
p.4
Factors Influencing Suicidal Intent
What factors before self-harm are associated with increased suicidal intent?
Planning in advance, writing a suicide note, giving away possessions, and recent discharge from a psychiatric unit.
p.3
Assessment of Self-Harm and Suicide Risk
What is assessed in the mental state examination?
Appearance, behavior, speech, mood, thought, perception, cognition, and insight.
p.1
Mental Health Conditions Associated with Self-Harm
What is a significant mental health condition associated with self-harm?
Mood disorders, including depression and bipolar disorder.
p.4
Management Strategies for Self-Harm
What are some biological management strategies for self-harm?
Inpatient or outpatient management and treating underlying mental illness, such as considering antidepressants.
p.1
Risk Factors for Self-Harm
What are the risk factors associated with self-harm?
Demographics, health conditions, personal factors, and life events.
p.1
Types of Self-Harm: Self-Poisoning vs. Self-Injury
What is the most common form of self-harm found in emergency departments?
Overdoses, particularly of paracetamol.
p.4
Prognosis and Repetition Rates of Self-Harm
What are some factors associated with the risk of repetition of self-harm?
Previous self-harm, personality disorder, hopelessness, history of psychiatric treatment, schizophrenia, substance abuse, living alone, impulsivity, co-morbidity, poor problem-solving ability, sexual abuse, and stressful life events.
p.2
Assessment of Self-Harm and Suicide Risk
What should be assessed regarding the circumstances surrounding a self-harm episode?
Events prior to the self-harm, psychosocial stressors, mental illness, degree of preparation, and planning.
p.2
Assessment of Self-Harm and Suicide Risk
What does the degree of preparation in self-harm refer to?
Planning, such as whether the act was planned or impulsive, and actions like leaving a suicide note.
p.3
Assessment of Self-Harm and Suicide Risk
What is included in the family history assessment for self-harm?
Family history of psychiatric illness and self-harm/suicide.
p.3
Risk Factors for Self-Harm
What aspects of alcohol and substance misuse history are important?
Misuse of alcohol and drugs.
p.3
Assessment of Self-Harm and Suicide Risk
What physical examination aspects are relevant for self-harm?
Physical damage from self-harm and ruling out organic illness.
