DELIBERATE SELF-HARM - A COMPARISON OF FIRST-TIME CASES AND CASES WITH A PRIOR HISTORY

Objective: Eighty one patients admitted following deliberate self-harm were assessed using a semistructured interview, The aim of the study was to compare clinical and social profiles of the 42 patients who had committed self harm for the first time with those of the 39 who had c ommitted self harm in the past. Method: The patients were assessed joi ntly by a psychiatrist and either a community psychiatric nurse or a s ocial worker, A description of past suicidal behaviour, socio demograp hic information, medical and psychiatric history were recorded. Suicid e intent was assessed both from the clinical interview and rated objec tively using Pierce's suicide intent scale, Psychiatric diagnoses were made using the ICD 9 classification. Results: The entire group had ex perienced difficulties in sustaining relationships, This problem was s ignificantly more widespread in repeaters with increased use of physic al violence in their relationship. More patients with a previous histo ry claimed to have death wishes at the time of self harm, and asserted that they would harm themselves again compared with patients without a previous history, Clinical predictions regarding future self harming behaviour were in line with the patient's stated intentions. Conclusi on: The persistent desire to commit self harm and more widespread rela tional difficulties amongst the patients with a previous history sugge sts a need for different treatment strategies and outcome measures for the two groups.