Comparing short-term risk of repeat self-harm after psychosocial assessment of patients who self-harm by psychiatrists or psychiatric nurses in a general hospital: cohort study
<p><strong>Background:</strong> There is mixed evidence for whether psychosocial assessment following hospital presentation for selfharm reduces self-harm repetition. A possible reason is the differences in professional background of assessors (primarily psychiatrists and psychiatr...
| Main Authors: | , , , , , , |
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| Format: | Journal article |
| Language: | English |
| Published: |
Elsevier
2020
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| _version_ | 1826284660284456960 |
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| author | Pitman, A Tsiachristas, A Casey, D Geulayov, G Brand, F Bale, E Hawton, K |
| author_facet | Pitman, A Tsiachristas, A Casey, D Geulayov, G Brand, F Bale, E Hawton, K |
| author_sort | Pitman, A |
| collection | OXFORD |
| description | <p><strong>Background:</strong> There is mixed evidence for whether psychosocial assessment following hospital presentation for selfharm reduces self-harm repetition. A possible reason is the differences in professional background of assessors (primarily psychiatrists and psychiatric nurses) due to variability in training and therapist style.</p>
<p><strong>Methods:</strong> Using data from the Oxford Monitoring System for Self-harm, we analysed data on patients making their first emergency department (ED) presentation for self-harm between 2000 and 2014, followed-up until 2015. Using logistic regression, we estimated the probability of repeat self-harm within 12 months, comparing: i) patients receiving psychosocial assessment versus none, adjusting for age, gender, self-harm method, past self-harm presentation, and medical admission; and ii) patients assessed by a psychiatric nurse versus those assessed by a psychiatrist, adjusting for age, self-harm method, time and year of presentation.</p>
<p><strong>Results:</strong> The 12,652 patients who had an index ED presentation for self-harm during the study period accounted for 24,450 presentations, in 17,303 (71%) of which a psychosocial assessment was conducted; in 9,318 (54%) by a psychiatric nurse and in 7,692 (45%) by a psychiatrist. We found a reduced probability of repeat self-harm presentation among patients receiving psychosocial assessment versus none (adjusted odds ratio [AOR]=0.70; 95% CI=0.65-0.75; p<0.001), but no differences between patients assessed by a psychiatric nurse or a psychiatrist (AOR=1.05; 95% CI=0.98-1.13; p=0.129). Limitations Findings from a single hospital may not be generalizable to other settings.</p>
<p><strong>Conclusions:</strong> Short-term risk of repeat self-harm after psychosocial assessment for self-harm may not differ by the assessor’s professional background.</p>
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| first_indexed | 2024-03-07T01:17:11Z |
| format | Journal article |
| id | oxford-uuid:8f18115f-c486-4e20-9a36-e99fa59bdb4f |
| institution | University of Oxford |
| language | English |
| last_indexed | 2024-03-07T01:17:11Z |
| publishDate | 2020 |
| publisher | Elsevier |
| record_format | dspace |
| spelling | oxford-uuid:8f18115f-c486-4e20-9a36-e99fa59bdb4f2022-03-26T23:02:03ZComparing short-term risk of repeat self-harm after psychosocial assessment of patients who self-harm by psychiatrists or psychiatric nurses in a general hospital: cohort studyJournal articlehttp://purl.org/coar/resource_type/c_dcae04bcuuid:8f18115f-c486-4e20-9a36-e99fa59bdb4fEnglishSymplectic ElementsElsevier2020Pitman, ATsiachristas, ACasey, DGeulayov, GBrand, FBale, EHawton, K<p><strong>Background:</strong> There is mixed evidence for whether psychosocial assessment following hospital presentation for selfharm reduces self-harm repetition. A possible reason is the differences in professional background of assessors (primarily psychiatrists and psychiatric nurses) due to variability in training and therapist style.</p> <p><strong>Methods:</strong> Using data from the Oxford Monitoring System for Self-harm, we analysed data on patients making their first emergency department (ED) presentation for self-harm between 2000 and 2014, followed-up until 2015. Using logistic regression, we estimated the probability of repeat self-harm within 12 months, comparing: i) patients receiving psychosocial assessment versus none, adjusting for age, gender, self-harm method, past self-harm presentation, and medical admission; and ii) patients assessed by a psychiatric nurse versus those assessed by a psychiatrist, adjusting for age, self-harm method, time and year of presentation.</p> <p><strong>Results:</strong> The 12,652 patients who had an index ED presentation for self-harm during the study period accounted for 24,450 presentations, in 17,303 (71%) of which a psychosocial assessment was conducted; in 9,318 (54%) by a psychiatric nurse and in 7,692 (45%) by a psychiatrist. We found a reduced probability of repeat self-harm presentation among patients receiving psychosocial assessment versus none (adjusted odds ratio [AOR]=0.70; 95% CI=0.65-0.75; p<0.001), but no differences between patients assessed by a psychiatric nurse or a psychiatrist (AOR=1.05; 95% CI=0.98-1.13; p=0.129). Limitations Findings from a single hospital may not be generalizable to other settings.</p> <p><strong>Conclusions:</strong> Short-term risk of repeat self-harm after psychosocial assessment for self-harm may not differ by the assessor’s professional background.</p> |
| spellingShingle | Pitman, A Tsiachristas, A Casey, D Geulayov, G Brand, F Bale, E Hawton, K Comparing short-term risk of repeat self-harm after psychosocial assessment of patients who self-harm by psychiatrists or psychiatric nurses in a general hospital: cohort study |
| title | Comparing short-term risk of repeat self-harm after psychosocial assessment of patients who self-harm by psychiatrists or psychiatric nurses in a general hospital: cohort study |
| title_full | Comparing short-term risk of repeat self-harm after psychosocial assessment of patients who self-harm by psychiatrists or psychiatric nurses in a general hospital: cohort study |
| title_fullStr | Comparing short-term risk of repeat self-harm after psychosocial assessment of patients who self-harm by psychiatrists or psychiatric nurses in a general hospital: cohort study |
| title_full_unstemmed | Comparing short-term risk of repeat self-harm after psychosocial assessment of patients who self-harm by psychiatrists or psychiatric nurses in a general hospital: cohort study |
| title_short | Comparing short-term risk of repeat self-harm after psychosocial assessment of patients who self-harm by psychiatrists or psychiatric nurses in a general hospital: cohort study |
| title_sort | comparing short term risk of repeat self harm after psychosocial assessment of patients who self harm by psychiatrists or psychiatric nurses in a general hospital cohort study |
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