Clinical and neuropsychological aspects of non-fatal self-harm in schizophrenia.
OBJECTIVE
To investigate demographic, clinical and neuropsychological aspects of self-harm in schizophrenia and identify which are independently predictive of and therefore the most relevant to clinical intervention.


METHODS
Eighty-seven patients with schizophrenia were interviewed regarding substance misuse, depression, hopelessness, negative/positive symptoms and illness insight. Neuropsychological assessment included premorbid IQ, continuous performance test, cognitive-motor and trait impulsivity. A prospective three-month review of medical records was also undertaken.


RESULTS
Fifty-nine patients (68%) reported past self-harm (including attempted suicide). Those with past self-harm, compared to those without, were significantly more likely to report depression, hopelessness, impulsivity, a family history of self-harm, polysubstance abuse and had higher premorbid IQ. Logistic regression revealed that depression, higher premorbid IQ and polysubstance abuse were independently linked to self-harm. Five participants attempted self-harm during the 3-month prospective follow-up period. These all had a history of past self-harm and were significantly more likely to have been depressed at the initial interview than those who did not go on to self-harm.


CONCLUSIONS
Independent predictors of self-harm in schizophrenia are premorbid IQ and polysubstance abuse. In addition, depression was both independently associated with past self-harm and predictive of self-harm in the follow-up period.
Academic Clinical Psychiatry, University of Sheffield, The Longley Centre, Norwood Grange Drive, Sheffield S5 7JT, United Kingdom. g.pluck@sheffield.ac.uk
G
G
Pluck
N P
NP
Lekka
S
S
Sarkar
K H
KH
Lee
P A
PA
Bath
O
O
Sharif
P W R
PW
Woodruff
D000328:Adult; D003071:Cognition; D005260:Female; D006801:Humans; D007175:Impulsive Behavior / Q000150:complications / Q000523:psychology; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests; D012559:Schizophrenia / Q000150:complications*; D012565:Schizophrenic Psychology; D016728:Self-Injurious Behavior / Q000150:complications / Q000523:psychology*; D013406:Suicide, Attempted / Q000523:psychology*