title: History of deliberate self-harm and its association with mood fluctuation.
abstract: BACKGROUND
  It is known that mental illness is associated with increased suicide risk. It has been postulated that suicidality may be an independent clinical phenomenon and we investigate whether variability of mood may be a mediator of this.
  
  
  METHODS
  Fifty-three psychiatric inpatients were assessed on the Montgomery-Asberg depression rating scale, once weekly, over a 4-week period. The SCID II was administered to diagnose co-morbid personality disorder. Hostility was measured with the Hostility and Direction of Hostility questionnaire. A Fluctuation Index score was calculated to measure variability of mood.
  
  
  RESULTS
  Unadjusted analyses suggested that patients with a history of deliberate self-harm showed greater variability in mood as measured by the fluctuation index (mean difference=13.4; 95% CI=4.3 to 22.6; P=0.005) though this relationship was no longer significant at the 5% level after adjustment (mean difference=13.4; 95% CI=-2.0 to 28.8; P=0.09).
  
  
  CONCLUSIONS
  There was a high initial dropout rate from the study and a small sample size. A prospective study would have more power in determining the effect of mood fluctuations.
  
  
  CONCLUSIONS
  Mood fluctuation may be a useful indicator of risk of deliberate self-harm and attempted suicide.
authors.affiliation: Dementia Research Group, National Hospital for Neurology and Neurosurgery, Queen Square, London WC1N 3BG, UK. l.sampson@dementia.ion.ucl.ac.uk
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Sampson
authors.forename: Sujoy
authors.initials: S
authors.lastname: Mukherjee
authors.forename: Obioha C
authors.initials: OC
authors.lastname: Ukoumunne
authors.forename: Nuala
authors.initials: N
authors.lastname: Mullan
authors.forename: Tim
authors.initials: T
authors.lastname: Bullock
mesh_terms: D000293:Adolescent; D000328:Adult; D000339:Affect; D015897:Comorbidity; D003430:Cross-Sectional Studies; D005260:Female; D006791:Hostility; D006801:Humans; D007297:Inpatients; D008297:Male; D008875:Middle Aged; D010554:Personality Disorders / Q000150:complications / Q000523:psychology*; D011569:Psychiatric Status Rating Scales; D016728:Self-Injurious Behavior / Q000523:psychology*; D013405:Suicide / Q000523:psychology*