Here is the selection of articles published in the months of October, November, December 2018, about suicide, self harm and suicidal related topics from the major scientific journals. Raffaella Calati worked for the selection. You can find here the articles presented with a short comment.
- Negative self-evaluation and the genesis of internal threat: beyond a continuum of suicidal thought and behaviour
Butter S, Shevlin M, Murphy J
Psychol Med. 2018 Dec 3:1-9. doi: 10.1017/S0033291718003562
In this British general population study (N = 8580), a broader negative self-evaluation (NSE) continuum was considered. Indicators of NSE were analyzed using exploratory factor analysis, confirmatory factor analysis and factor mixture modelling. A 4-factor model that reflected graded levels of NSE was identified: (F1) Low self-worth & subordination (F2) depression, (F3) suicidal thoughts, (F4) self-harm (SH). Hence, low self-worth, subordination and depression, while representative of distinct groups in the
population, are also highly prevalent in individuals with suicidal thoughts and SH behavior.
Items 1 – 3 of 3
- Self-harm in a primary care cohort of older people: incidence, clinical management, and risk of suicide and other causes of death
Morgan C, Webb RT, Carr MJ, Kontopantelis E, Chew-Graham CA, Kapur N, Ashcroft DM
Lancet Psychiatry. 2018 Oct 15. pii: S2215-0366(18)30348-1. doi: 10.1016/S2215-0366(18)30348-1
In this primary care cohort study performed in UK, 4124 older adults (aged 65 years and older) with a self-harm episode were ascertained in the Clinical Practice Research Datalink (recorded during 2001-14).
Authors performed multiple analyses: 1) they calculated the standardised incidence of self-harm; 2) in a sub-sample (n=2854) with at least 12 months follow-up, they examined the frequency of psychiatric referrals and prescription of psychotropic medication after self-harm; 3) they estimated prevalence of mental and physical illness diagnoses before and after self-harm in a matched cohort; 4) they examined cause-specific mortality risks. Concerning results 1), 2), and 3) we invite you to read the paper. Focusing on 4) older adults from the self-harm cohort (n=2454) died from unnatural causes 20 times more frequently than the comparison cohort (n=48 921) during the first year, with an elevated risk of suicide in the self-harm cohort. These findings emphasize the need for early intervention and increased support after an episode of self-harm among older adults.
Items 2 – 3 of 3
- Dialectical behaviour therapy v. mentalisation-based therapy for borderline personality disorder
Barnicot K, Crawford M
Psychol Med. 2018 Oct 10:1-9. doi: 10.1017/S0033291718002878
The first (non-randomised) comparison between Dialectical Behaviour Therapy (DBT) and Mentalisation-Based Therapy (MBT) has been performed on 90 borderline personality disorder (BPD) patients receiving either DBT or MBT over a 12-month period. Participants receiving DBT reported a significantly steeper decline over time in incidents of self-harm and in emotional dysregulation than participants receiving MBT, after adjusting for potentially confounding variables.
In the future we need to address the question if the DBT’s explicit focus on targeting self-harm reduction and improving emotion regulation skills may render it a more rapidly acting treatment for these difficulties.
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