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Clinical characteristics of patients with self harming behaviour in a low secure mental health unit

Published online by Cambridge University Press:  27 November 2009

M Dominic Beer*
Consultant Psychiatrist in Challenging Behaviour and Intensive Care Psychiatry, Oxleas NHS Foundation Trust and Senior Lecturer, Division of Psychological Medicine, Institute of Psychiatry, London, UK
Anandamurugan Muthukumaraswamy
Specialist Registrar, St Thomas’ Hospital, South London and Maudsley NHS Foundation Trust, London, UK
Al Aditya Khan
Speciality Registrar 4, Forensic Psychiatry, Hampshire Partnership NHS Trust, Southampton, UK
Mohammad Arif Musabbir
Speciality Registrar 1, Leeds Mental Health Foundation Trust, Leeds, UK
Correspondence to: Dr M. D. Beer, Bracton Centre, Oxleas NHS Foundation Trust, Bracton Lane, Dartford, Kent, DA2 7AF, UK. E-mail:
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Aims: To describe the methods of self harm incidents in a low secure unit population and to identify and compare the clinical characteristics of patients displaying inpatient self harming behaviours with those who do not display such behaviours.

Method: A retrospective case control study was conducted. Details about the inpatient self harming incidents were collected from an incident database. Clinical characteristics of those who displayed inpatient self harming incidents (cases) and those who did not display such behaviours (controls) were compared. Analysis was performed to establish statistical significance on the observed differences.

Results: 80 admissions resulted from 78 patients during a 6½ year period. 21% of patients presented with inpatient self harming behaviours. 57% of the incidents were caused by 13% of patients. Clinical characteristics such as white ethnic background, histories of self harm, physical or sexual abuse, childhood conduct problems and lack of educational qualifications and having a diagnosis of schizoaffective disorder were more likely to be associated with inpatients self harming in low secure settings. Sexually inappropriate behaviours and a diagnosis of schizophrenia were less likely to be associated with this group.

Conclusion: The majority of self harm incidents are caused by a minority of patients. Most of the clinical characteristics associated with the low secure inpatient self harming patients are similar to those observed in other psychiatric inpatient settings.

Original Paper
Copyright © NAPICU 2009

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