Pain and deliberate self-harm: an important association.
OBJECTIVE
The aim of this study was to establish how often pain was a factor contributing to an episode of deliberate self-harm.


METHODS
Retrospective case note examination of all deliberate self-harm patients with concurrent medical problems admitted to a general hospital over 2 years.


RESULTS
Pain was considered to be a contributory factor in the episode of deliberate self-harm in 75 (4%) of the total number of episodes of deliberate self-harm (1665) over the 2-year period. These patients were older and had higher suicide intent scores, but lower rates of previous psychiatric illness or alcohol or drug misuse than did the deliberate self-harm patients with medical problems but no pain. Although 60% had experienced pain for more than 6 months only, 8 (12%) were attending the local Pain Clinic at the time of the deliberate self-harm.


CONCLUSIONS
We propose closer collaboration between general hospital services and local pain clinics for deliberate self-harm patients with painful disorders. Clinicians need to assess suicidal ideation and risk of self-harm when prescribing for this population.
University Department of Psychiatry, Warneford Hospital, Oxford OX3 7JX, England, UK.
Megan
M
Theodoulou
Louise
L
Harriss
Keith
K
Hawton
Christopher
C
Bass
D000328:Adult; D015984:Causality; D002908:Chronic Disease; D015897:Comorbidity; D003299:Cooperative Behavior; D062787:Drug Overdose / Q000453:epidemiology / Q000523:psychology; D005260:Female; D006769:Hospitals, General; D006801:Humans; D016015:Logistic Models; D008297:Male; D010146:Pain / Q000453:epidemiology / Q000523:psychology*; D018710:Pain Clinics; D011567:Psychiatric Department, Hospital; D012307:Risk Factors; D016728:Self-Injurious Behavior / Q000453:epidemiology / Q000523:psychology*; D013223:Statistics as Topic; D013406:Suicide, Attempted / Q000523:psychology / Q000706:statistics & numerical data