Deliberate self-poisoning and self-injury in the psychiatric hospital

Acts of self-poisoning and self-injury carried out by in-patients and day patients while in treatment at two psychiatric hospitals were recorded over a one-year period. Comparison with results from a survey based on referrals to a general hospital in the same area demonstrated that the rate at which these events occurred was over 50 times greater for patients in psychiatric care than in the general population. A larger proportion of the psychiatric hospital incidents involved self-injury. Analysis of the records of a consecutive series of all psychiatric hospital patients revealed that at least one-third had a previous history of self-poisoning or self-injury. Of the patients carrying out such acts in one hospital, 77 per cent had a history of this behaviour prior to admission. Clusters of incidents were identified. Possible factors underlying this behaviour in the hospital setting and means of prevention are suggested.

Accidents in a psychiatric hospital

In a six-month study of psychiatric hospital in-patients, it was found that accidents more often occurred among females and among patients on psychogeriatric wards. Falls were the most common form of accident. Accidents resulting from the aggressive behaviour of other patients usually occurred on long-stay and rehabilitation wards, with middle-aged patients the victims.

Attempted suicide and suicide among Oxford University students

A lower incidence of attempted suicide was found for Oxford University students than for other persons of the same age in Oxford City. This may be due to social class differences. Characteristics of the student attempters are reported. On the other hand, the rates for completed suicides of students, over a recent ten-year period, were in excess of those for the rest of their age group.

Deliberate self-poisoning: implications for psychotropic drug prescribing in general practice

Several surveys have confirmed that the majority of patients who take an overdose of drugs have seen their general practitioner within the preceding few weeks; as many as a third attend within the previous week.We studied 130 patients who had taken an overdose and interviewed 122 of the general practitioners. We found that they had identified many interpersonal problems and had usually prescribed psychotropic drugs.We question the wisdom of this response and suggest other ways of handling such problems in general practice.

General practice aspects of self-poisoning and self-injury

A sample of individuals who had carried out acts of self-poisoning or self-injury were interviewed and information was also obtained from their general practitioners. More of both the men and the women had visited their general practitioners in the year before the acts than would have been predicted from national statistics, although this was not found to the same extent for persons aged 16-24. Thirty-six per cent of the sample had contacted their general practitioners during the week before the act and over 60% in the month beforehand. Sixty-three per cent had visited them for a variety of psychiatric and social reasons during the preceding year and had nearly all been prescribed psychotropic drugs, usually tranquillizers or sedatives. These were commonly the drugs taken in acts of self-poisoning. Methods of prevention are discussed.