TY  - JOUR
PY  - 2023//
TI  - Mental health disorders, functioning and health-related quality of life among extensively hospitalized patients due to severe self-harm - results from the Extreme Challenges project
JO  - Frontiers in psychiatry
A1  - Langjord, Tuva
A1  - Pedersen, Geir
A1  - Bovim, Tone
A1  - Christensen, Tore Buer
A1  - Eikenæs, Ingeborg Ulltveit-Moe
A1  - Hove, Oddbjørn
A1  - Kildahl, Arvid Nikolai
A1  - Mork, Erlend
A1  - Norheim, Astrid Berge
A1  - Ramleth, Ruth Kari
A1  - Ringen, Petter Andreas
A1  - Romm, Kristin Lie
A1  - Siqveland, Johan
A1  - Schønning, Thea
A1  - Stänicke, Line
A1  - Torgersen, Terje
A1  - Pettersen, Mona
A1  - Tveit, Tone
A1  - Urnes, Øyvind
A1  - Walby, Fredrik
A1  - Kvarstein, Elfrida Hartveit
SP  - e1258025
EP  - e1258025
VL  - 14
IS  - 
N2  - BACKGROUND: Severe self-harm leading to extensive hospitalization generates extreme challenges for patients, families, and health services. Controversies regarding diagnoses and health care often follow. Most evidence-based treatments targeting self-harm are designed for borderline personality disorder (BPD). However, current knowledge about mental health status among individuals with severe self-harm is limited. <br><br>OBJECTIVES: To investigate psychopathology among patients extensively hospitalized due to severe or frequent self-harming behaviors. <br><br>METHOD: A cross sectional study (period 2019-2021) targeting psychiatric inpatients (>18 years) with frequent (>5) or long (>4 weeks) admissions last year due to self-harm. The target sample (N = 42, from 12 hospitals across all Norwegian health regions) was compared to individuals admitted to outpatient personality disorder (PD) treatment within specialist mental health services in the same period (N = 389). Clinicians performed interviews on self-harm and psychopathology, supplemented by self-report. <br><br>RESULTS: The target sample were young adults, mainly female, with considerable hospitalization and self-harming behaviors, both significantly more extensive than the comparison group. The majority in both groups reported self-harm onset <18 years. The target sample reported increasing severity of self-harm acts and suicidal intention over time. Both samples had high levels of childhood trauma, impaired personality functioning, and a majority fulfilled criteria for PD. In the target sample, comorbid depression, PTSD, anxiety disorders, and substance use occurred more frequently and in 50%, psychosis/dissociative disorder/autism spectrum disorder/ADHD was reported (outpatient comparison sample: 9%). 35% in the target sample screened over cut-off for possible intellectual disability. The target sample reported poor psychosocial functioning and health-related quality of life - greater impairment than the outpatient comparison sample. <br><br>CONCLUSION: The study reveals that severe self-harm inpatients have complex psychopathology and highlights the importance of individualized and thorough assessment among patients with severe and/or repetitive self-harm.<p />  <p>Language: en</p>
LA  - en
SN  - 1664-0640
UR  - http://dx.doi.org/10.3389/fpsyt.2023.1258025
ID  - ref1
ER  -