Correspondence |
*Oxfordshire and Buckinghamshire Mental Health NHS Foundation Trust, Shrublands Day Hospital, Queens Road, High Wycombe HP13 6PT, email: megan.theodoulou{at}obmh.nhs.uk
Department of Psychological Medicine, John Radcliffe Hospital, Oxford OX3 9DU
Some older people with pain-related physical problems are at high risk of suicide (Psychiatric Bulletin, March 2008, 32, 92-95). This is a neglected field of research.
We carried out a retrospective case note study of all individuals admitted to a general hospital after presenting to accident and emergency with self-harm and concurrent medical problems. Pain contributed to the episode of self-harm in 4% of cases. The mean age of these individuals was 46 years; 60% had experienced pain for over 6 months and 35% had a history of psychiatric disorder. They had a significantly higher suicidal intent associated with their acts of self-harm than those with non-painful physical problems (44% v. 30% respectively).
We recommended closer collaboration between general hospital services and local pain clinics for treating individuals with painful disorders who self-harm. Furthermore, we would encourage all clinicians to assess suicidal ideation and risk of self-harm when prescribing for this group. This is particularly important when considering prescribing analgesics or tricyclic antidepressants.
References
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