Diss. (sammanfattning) Stockholm : Karol. inst. / Härtill 6 uppsatser.

A Dissertation Submitted to the Faculty of Medicine, University of the witwatersrand, Johannesburg, in part fulfilment of the requirements for the Degree of Master of Medicine in psychiatry. / A descriptive study of 130 suicide attempts seen at the psychiatric department, Baragwanath Hospital during the six month period 01/01/89 to 30/06/89 is presented. Demographic, clinical and psychosocial data were reviewed and discussed. A follow-up assessment was done six months after the suicide attempt. The patients who had attempted suicide made up 10% of the patients seen at the psychiatric department. Seventy six percent of the patients that attempted suicide were under the age of 30 years. The male:female ratio was 1:2. The ingestion of chemicals (65%) was the predominant method used, The major predisposing factor was interpersonal conflict (70%). It was found that these patients were less likely than whites to have previously self-poisoned, have received previous psychiatric treatment, or be suffering from depression or a personality disorder. Sixty nine percent of the patients were given follow-up appointments. There was a poor followup rate (25%). A recurrence of suicidal behaviour within six months was 4%. / Andrew Chakane 2018

Diss. (sammanfattning) Uppsala : Univ., 2003. / Härtill 5 uppsatser.

This study aims to describe the relationship of personality disorders to the repetition of parasuicide whilst taking cognizance of recent developments in the classification of and assessment for personality disorders. This study also aims to determine whether risk factors described by other authors for further suicidal behavior are characteristic of these patients locally. This study also aims to describe the contribution of newly described personality dimensions to repetition of parasuicide. This study also describes suicidal behavior in the follow-up period of a cohort of parasuicide patients who were seen in the emergency psychiatric service during follow-up. This study also examines the comorbidity between the personality disorders categories defined by the clinical criteria of the Tenth International Classification of Mental and Behavioral Disorders or ICD-10, (World Health organization, 1992). This study compares the co-occurence of these new personality disorder categories with the comorbidity which has been observed in older classification systems (American Psychiatric Association; 1980, 1987) in order to determine whether this new classification system has led to less comorbidity among the personality disorders. This study also examines aspects of the relationship between informant based diagnoses of personality disorder and personality dimensions described by Cloninger et al (1994).

Diss. (sammanfattning) Stockholm : Karol. inst., 2005. / Härtill 4 uppsatser.

Submitted in partial fulfillment of the requirement for the degree Master of Science in Emergency Medicine in the Faculty of Health Sciences at the University of Witwatersrand , July 2013 / Background Deliberate self-poisoning (DSP) remains a common method employed for suicide worldwide. Despite its frequent occurrence and the high cost required in its management, only few studies have been carried out on this subject in South Africa. Inadequate research into DSP in South Africa is a great concern as this may inadvertently result in an inadequate knowledge of health professionals on the general approach to victims presenting at emergency departments. This may consequently result in a poor clinical outcome of these cases. This study was aimed at determining the demographics of DSP cases presenting to the emergency department (ED) of Pelonomi hospital and also to enquire into the drugs/agents commonly used, reasons for DSP and the clinical outcome of these cases. Method This was a retrospective, descriptive study which was carried out by going through the hospital clinical records covering a period of eighteen months (1st January 2010 – 30th June 2011). The demographics and deliberate self-poisoning-related information were then collected, using a data collection form. The data was thereafter analysed by using descriptive statistics, calculated for continuous data. Frequencies and percentages were calculated for categorical data. Results Of the 212 DSP cases reviewed, 66% were female. Most patients (86.8%) were single and 65.6% were unemployed. DSP occurred more in the age-group of 20-39 years (68.8%). Majority of the DSP cases (84.4%) occurred in areas associated with poor socio-economic status.Paracetamol was the drug used by majority of these patients (21.7%) for DSP. Other common agents/drugs used were antidepressants (9.4%), antiretrovirals (ARVs) (9.9%) and household chemicals (19.3%). 85 patients (40.1%) took more than one drug/agent. Out of the 81 patients who had the reason for their poisoning stated, 40 patients had relationship disharmony (32 unmarried, 8 married). 15 patients had family issues which mainly resulted from conflicts with parents and grandparents. The medical reasons found amongst 5 patients were HIV infection, cancer and dental problems. Unemployment and post traumatic stress disorder following rape were the other reasons for DSP. The psychosocial problems of 10 patients were not specified. Majority of the patients (59.9%) were discharged in stable conditions. Low GCS (≤8) and hypothermia were common clinical features occurring amongst patients that got admitted. Conclusion DSP is still a common phenomenon, majorly amongst females in the age-group of 20-39 years, with poor quality of life. Relationship disharmony is the most common reason for poisoning. Drug/agents used can only be curtailed to a minimal extent. Prevention through early detection of vulnerable patients and early psychological management should be our goal.

Objective: Describe emergency department (ED) presentations for self-harm by youth (12-17 yearolds), including the mental health follow-up they receive after their first-ever presentation, and analyze the association between this mental health follow-up and repeat presentation(s). Methods: Population-based health services data from Ontario, Canada, covering April 2002 to March 2009, were used to ascertain ED presentations for self-harm by youth (n=16,835). These data were used to create a retrospective cohort (n=3,497) of those making their first-ever presentation, and individually-linked to inpatient admission and ambulatory physician contact data. Mental health follow-up within 30-days of discharge, either from a psychiatrist or from any physician specialty, was assessed. The associations between follow-up and repeat self-harm presentation(s) within the following year were then analyzed. Results: Conservatively, the overall incidence rate for ED presentations for self-harm by Ontario youth was 239.0 per 100,000 person-years. Rates were higher in girls, increased with age and inversely related to neighbourhood income and community size (population). Self-harm made up a small but severe proportion of ED use by youth. Over half (57.2%) making their first-ever self-harm presentation had no mental health contact with a physician within 30 days of discharge (and several demographic, clinical and health service variables were associated with follow-up). However, mental health follow-up was not associated with reduced odds of repetition or fewer repeat presentations. Conclusions: ED presentations for self-harm by youth in Ontario are remarkably consistent with those reported from other Western countries. Self-harm is an important public health issue in Canada and requires a comprehensive prevention strategy. These data suggested follow-up youth received after their first-ever ED presentation for self-harm may be inadequate and strategies to improve follow-up may be needed. Still, more research is needed to establish the effect of follow-up on relevant outcomes.

Objective: Describe emergency department (ED) presentations for self-harm by youth (12-17 yearolds), including the mental health follow-up they receive after their first-ever presentation, and analyze the association between this mental health follow-up and repeat presentation(s). Methods: Population-based health services data from Ontario, Canada, covering April 2002 to March 2009, were used to ascertain ED presentations for self-harm by youth (n=16,835). These data were used to create a retrospective cohort (n=3,497) of those making their first-ever presentation, and individually-linked to inpatient admission and ambulatory physician contact data. Mental health follow-up within 30-days of discharge, either from a psychiatrist or from any physician specialty, was assessed. The associations between follow-up and repeat self-harm presentation(s) within the following year were then analyzed. Results: Conservatively, the overall incidence rate for ED presentations for self-harm by Ontario youth was 239.0 per 100,000 person-years. Rates were higher in girls, increased with age and inversely related to neighbourhood income and community size (population). Self-harm made up a small but severe proportion of ED use by youth. Over half (57.2%) making their first-ever self-harm presentation had no mental health contact with a physician within 30 days of discharge (and several demographic, clinical and health service variables were associated with follow-up). However, mental health follow-up was not associated with reduced odds of repetition or fewer repeat presentations. Conclusions: ED presentations for self-harm by youth in Ontario are remarkably consistent with those reported from other Western countries. Self-harm is an important public health issue in Canada and requires a comprehensive prevention strategy. These data suggested follow-up youth received after their first-ever ED presentation for self-harm may be inadequate and strategies to improve follow-up may be needed. Still, more research is needed to establish the effect of follow-up on relevant outcomes.

Diss. (sammanfattning) Umeå : Univ., 2004. / Härtill 5 uppsatser.

Diss. (sammanfattning) Stockholm : Karolinska institutet, 2006. / Härtill 5 uppsatser.