Absolute risks of self-harm and interpersonal violence by diagnostic category following first discharge from inpatient psychiatric care

Abstract Background Persons discharged from inpatient psychiatric services are at greatly elevated risk of harming themselves or inflicting violence on others, but no studies have reported gender-specific absolute risks for these two outcomes across the spectrum of psychiatric diagnoses. We aimed t...
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Autor*in:	P. L. H. Mok [verfasserIn] F. Walter [verfasserIn] M. J. Carr [verfasserIn] S. Antonsen [verfasserIn] N. Kapur [verfasserIn] S. Steeg [verfasserIn] J. Shaw [verfasserIn] C. B. Pedersen [verfasserIn] R. T. Webb [verfasserIn]

Format:	E-Artikel
Sprache:	Englisch

Erschienen:	2023

Schlagwörter:	Discharge from inpatient care interpersonal violence psychiatric illness self-harm substance misuse

Übergeordnetes Werk:	In: European Psychiatry - Cambridge University Press, 2020, 66(2023)
Übergeordnetes Werk:	volume:66 ; year:2023

Links:	Link aufrufen Link aufrufen Link aufrufen Journal toc Journal toc

DOI / URN:	10.1192/j.eurpsy.2022.2352

Katalog-ID:	DOAJ088115666

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520			\|a Abstract Background Persons discharged from inpatient psychiatric services are at greatly elevated risk of harming themselves or inflicting violence on others, but no studies have reported gender-specific absolute risks for these two outcomes across the spectrum of psychiatric diagnoses. We aimed to estimate absolute risks for self-harm and interpersonal violence post-discharge according to gender and diagnostic category. Methods Danish national registry data were utilized to investigate 62,922 discharged inpatients, born 1967–2000. An age and gender matched cohort study was conducted to examine risks for self-harm and interpersonal violence at 1 year and at 10 years post-discharge. Absolute risks were estimated as cumulative incidence percentage values. Results Patients diagnosed with substance misuse disorders were at especially elevated risk, with the absolute risks for either self-harm or interpersonal violence being 15.6% (95% CI 14.9, 16.3%) of males and 16.8% (15.6, 18.1%) of females at 1 year post-discharge, rising to 45.7% (44.5, 46.8%) and 39.0% (37.1, 40.8%), respectively, within 10 years. Diagnoses of personality disorders and early onset behavioral and emotional disorders were also associated with particularly high absolute risks, whilst risks linked with schizophrenia and related disorders, mood disorders, and anxiety/somatoform disorders, were considerably lower. Conclusions Patients diagnosed with substance misuse disorders, personality disorders and early onset behavioral and emotional disorders are at especially high risk for internally and externally directed violence. It is crucial, however, that these already marginalized individuals are not further stigmatized. Enhanced care at discharge and during the challenging transition back to life in the community is needed.
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allfields	10.1192/j.eurpsy.2022.2352 doi (DE-627)DOAJ088115666 (DE-599)DOAJb1bf27196bad4a498ca0f840793a222b DE-627 ger DE-627 rakwb eng RC435-571 P. L. H. Mok verfasserin aut Absolute risks of self-harm and interpersonal violence by diagnostic category following first discharge from inpatient psychiatric care 2023 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Abstract Background Persons discharged from inpatient psychiatric services are at greatly elevated risk of harming themselves or inflicting violence on others, but no studies have reported gender-specific absolute risks for these two outcomes across the spectrum of psychiatric diagnoses. We aimed to estimate absolute risks for self-harm and interpersonal violence post-discharge according to gender and diagnostic category. Methods Danish national registry data were utilized to investigate 62,922 discharged inpatients, born 1967–2000. An age and gender matched cohort study was conducted to examine risks for self-harm and interpersonal violence at 1 year and at 10 years post-discharge. Absolute risks were estimated as cumulative incidence percentage values. Results Patients diagnosed with substance misuse disorders were at especially elevated risk, with the absolute risks for either self-harm or interpersonal violence being 15.6% (95% CI 14.9, 16.3%) of males and 16.8% (15.6, 18.1%) of females at 1 year post-discharge, rising to 45.7% (44.5, 46.8%) and 39.0% (37.1, 40.8%), respectively, within 10 years. Diagnoses of personality disorders and early onset behavioral and emotional disorders were also associated with particularly high absolute risks, whilst risks linked with schizophrenia and related disorders, mood disorders, and anxiety/somatoform disorders, were considerably lower. Conclusions Patients diagnosed with substance misuse disorders, personality disorders and early onset behavioral and emotional disorders are at especially high risk for internally and externally directed violence. It is crucial, however, that these already marginalized individuals are not further stigmatized. Enhanced care at discharge and during the challenging transition back to life in the community is needed. Discharge from inpatient care interpersonal violence psychiatric illness self-harm substance misuse Psychiatry F. Walter verfasserin aut M. J. Carr verfasserin aut S. Antonsen verfasserin aut N. Kapur verfasserin aut S. Steeg verfasserin aut J. Shaw verfasserin aut C. B. Pedersen verfasserin aut R. T. Webb verfasserin aut In European Psychiatry Cambridge University Press, 2020 66(2023) (DE-627)320445070 (DE-600)2005377-0 17783585 nnns volume:66 year:2023 https://doi.org/10.1192/j.eurpsy.2022.2352 kostenfrei https://doaj.org/article/b1bf27196bad4a498ca0f840793a222b kostenfrei https://www.cambridge.org/core/product/identifier/S0924933822023525/type/journal_article kostenfrei https://doaj.org/toc/0924-9338 Journal toc kostenfrei https://doaj.org/toc/1778-3585 Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_217 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_374 GBV_ILN_602 GBV_ILN_636 GBV_ILN_2004 GBV_ILN_2014 GBV_ILN_2110 GBV_ILN_2336 GBV_ILN_2470 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 66 2023
spelling	10.1192/j.eurpsy.2022.2352 doi (DE-627)DOAJ088115666 (DE-599)DOAJb1bf27196bad4a498ca0f840793a222b DE-627 ger DE-627 rakwb eng RC435-571 P. L. H. Mok verfasserin aut Absolute risks of self-harm and interpersonal violence by diagnostic category following first discharge from inpatient psychiatric care 2023 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Abstract Background Persons discharged from inpatient psychiatric services are at greatly elevated risk of harming themselves or inflicting violence on others, but no studies have reported gender-specific absolute risks for these two outcomes across the spectrum of psychiatric diagnoses. We aimed to estimate absolute risks for self-harm and interpersonal violence post-discharge according to gender and diagnostic category. Methods Danish national registry data were utilized to investigate 62,922 discharged inpatients, born 1967–2000. An age and gender matched cohort study was conducted to examine risks for self-harm and interpersonal violence at 1 year and at 10 years post-discharge. Absolute risks were estimated as cumulative incidence percentage values. Results Patients diagnosed with substance misuse disorders were at especially elevated risk, with the absolute risks for either self-harm or interpersonal violence being 15.6% (95% CI 14.9, 16.3%) of males and 16.8% (15.6, 18.1%) of females at 1 year post-discharge, rising to 45.7% (44.5, 46.8%) and 39.0% (37.1, 40.8%), respectively, within 10 years. Diagnoses of personality disorders and early onset behavioral and emotional disorders were also associated with particularly high absolute risks, whilst risks linked with schizophrenia and related disorders, mood disorders, and anxiety/somatoform disorders, were considerably lower. Conclusions Patients diagnosed with substance misuse disorders, personality disorders and early onset behavioral and emotional disorders are at especially high risk for internally and externally directed violence. It is crucial, however, that these already marginalized individuals are not further stigmatized. Enhanced care at discharge and during the challenging transition back to life in the community is needed. Discharge from inpatient care interpersonal violence psychiatric illness self-harm substance misuse Psychiatry F. Walter verfasserin aut M. J. Carr verfasserin aut S. Antonsen verfasserin aut N. Kapur verfasserin aut S. Steeg verfasserin aut J. Shaw verfasserin aut C. B. Pedersen verfasserin aut R. T. Webb verfasserin aut In European Psychiatry Cambridge University Press, 2020 66(2023) (DE-627)320445070 (DE-600)2005377-0 17783585 nnns volume:66 year:2023 https://doi.org/10.1192/j.eurpsy.2022.2352 kostenfrei https://doaj.org/article/b1bf27196bad4a498ca0f840793a222b kostenfrei https://www.cambridge.org/core/product/identifier/S0924933822023525/type/journal_article kostenfrei https://doaj.org/toc/0924-9338 Journal toc kostenfrei https://doaj.org/toc/1778-3585 Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_217 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_374 GBV_ILN_602 GBV_ILN_636 GBV_ILN_2004 GBV_ILN_2014 GBV_ILN_2110 GBV_ILN_2336 GBV_ILN_2470 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 66 2023
allfields_unstemmed	10.1192/j.eurpsy.2022.2352 doi (DE-627)DOAJ088115666 (DE-599)DOAJb1bf27196bad4a498ca0f840793a222b DE-627 ger DE-627 rakwb eng RC435-571 P. L. H. Mok verfasserin aut Absolute risks of self-harm and interpersonal violence by diagnostic category following first discharge from inpatient psychiatric care 2023 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Abstract Background Persons discharged from inpatient psychiatric services are at greatly elevated risk of harming themselves or inflicting violence on others, but no studies have reported gender-specific absolute risks for these two outcomes across the spectrum of psychiatric diagnoses. We aimed to estimate absolute risks for self-harm and interpersonal violence post-discharge according to gender and diagnostic category. Methods Danish national registry data were utilized to investigate 62,922 discharged inpatients, born 1967–2000. An age and gender matched cohort study was conducted to examine risks for self-harm and interpersonal violence at 1 year and at 10 years post-discharge. Absolute risks were estimated as cumulative incidence percentage values. Results Patients diagnosed with substance misuse disorders were at especially elevated risk, with the absolute risks for either self-harm or interpersonal violence being 15.6% (95% CI 14.9, 16.3%) of males and 16.8% (15.6, 18.1%) of females at 1 year post-discharge, rising to 45.7% (44.5, 46.8%) and 39.0% (37.1, 40.8%), respectively, within 10 years. Diagnoses of personality disorders and early onset behavioral and emotional disorders were also associated with particularly high absolute risks, whilst risks linked with schizophrenia and related disorders, mood disorders, and anxiety/somatoform disorders, were considerably lower. Conclusions Patients diagnosed with substance misuse disorders, personality disorders and early onset behavioral and emotional disorders are at especially high risk for internally and externally directed violence. It is crucial, however, that these already marginalized individuals are not further stigmatized. Enhanced care at discharge and during the challenging transition back to life in the community is needed. Discharge from inpatient care interpersonal violence psychiatric illness self-harm substance misuse Psychiatry F. Walter verfasserin aut M. J. Carr verfasserin aut S. Antonsen verfasserin aut N. Kapur verfasserin aut S. Steeg verfasserin aut J. Shaw verfasserin aut C. B. Pedersen verfasserin aut R. T. Webb verfasserin aut In European Psychiatry Cambridge University Press, 2020 66(2023) (DE-627)320445070 (DE-600)2005377-0 17783585 nnns volume:66 year:2023 https://doi.org/10.1192/j.eurpsy.2022.2352 kostenfrei https://doaj.org/article/b1bf27196bad4a498ca0f840793a222b kostenfrei https://www.cambridge.org/core/product/identifier/S0924933822023525/type/journal_article kostenfrei https://doaj.org/toc/0924-9338 Journal toc kostenfrei https://doaj.org/toc/1778-3585 Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_217 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_374 GBV_ILN_602 GBV_ILN_636 GBV_ILN_2004 GBV_ILN_2014 GBV_ILN_2110 GBV_ILN_2336 GBV_ILN_2470 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 66 2023
allfieldsGer	10.1192/j.eurpsy.2022.2352 doi (DE-627)DOAJ088115666 (DE-599)DOAJb1bf27196bad4a498ca0f840793a222b DE-627 ger DE-627 rakwb eng RC435-571 P. L. H. Mok verfasserin aut Absolute risks of self-harm and interpersonal violence by diagnostic category following first discharge from inpatient psychiatric care 2023 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Abstract Background Persons discharged from inpatient psychiatric services are at greatly elevated risk of harming themselves or inflicting violence on others, but no studies have reported gender-specific absolute risks for these two outcomes across the spectrum of psychiatric diagnoses. We aimed to estimate absolute risks for self-harm and interpersonal violence post-discharge according to gender and diagnostic category. Methods Danish national registry data were utilized to investigate 62,922 discharged inpatients, born 1967–2000. An age and gender matched cohort study was conducted to examine risks for self-harm and interpersonal violence at 1 year and at 10 years post-discharge. Absolute risks were estimated as cumulative incidence percentage values. Results Patients diagnosed with substance misuse disorders were at especially elevated risk, with the absolute risks for either self-harm or interpersonal violence being 15.6% (95% CI 14.9, 16.3%) of males and 16.8% (15.6, 18.1%) of females at 1 year post-discharge, rising to 45.7% (44.5, 46.8%) and 39.0% (37.1, 40.8%), respectively, within 10 years. Diagnoses of personality disorders and early onset behavioral and emotional disorders were also associated with particularly high absolute risks, whilst risks linked with schizophrenia and related disorders, mood disorders, and anxiety/somatoform disorders, were considerably lower. Conclusions Patients diagnosed with substance misuse disorders, personality disorders and early onset behavioral and emotional disorders are at especially high risk for internally and externally directed violence. It is crucial, however, that these already marginalized individuals are not further stigmatized. Enhanced care at discharge and during the challenging transition back to life in the community is needed. Discharge from inpatient care interpersonal violence psychiatric illness self-harm substance misuse Psychiatry F. Walter verfasserin aut M. J. Carr verfasserin aut S. Antonsen verfasserin aut N. Kapur verfasserin aut S. Steeg verfasserin aut J. Shaw verfasserin aut C. B. Pedersen verfasserin aut R. T. Webb verfasserin aut In European Psychiatry Cambridge University Press, 2020 66(2023) (DE-627)320445070 (DE-600)2005377-0 17783585 nnns volume:66 year:2023 https://doi.org/10.1192/j.eurpsy.2022.2352 kostenfrei https://doaj.org/article/b1bf27196bad4a498ca0f840793a222b kostenfrei https://www.cambridge.org/core/product/identifier/S0924933822023525/type/journal_article kostenfrei https://doaj.org/toc/0924-9338 Journal toc kostenfrei https://doaj.org/toc/1778-3585 Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_217 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_374 GBV_ILN_602 GBV_ILN_636 GBV_ILN_2004 GBV_ILN_2014 GBV_ILN_2110 GBV_ILN_2336 GBV_ILN_2470 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 66 2023
allfieldsSound	10.1192/j.eurpsy.2022.2352 doi (DE-627)DOAJ088115666 (DE-599)DOAJb1bf27196bad4a498ca0f840793a222b DE-627 ger DE-627 rakwb eng RC435-571 P. L. H. Mok verfasserin aut Absolute risks of self-harm and interpersonal violence by diagnostic category following first discharge from inpatient psychiatric care 2023 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Abstract Background Persons discharged from inpatient psychiatric services are at greatly elevated risk of harming themselves or inflicting violence on others, but no studies have reported gender-specific absolute risks for these two outcomes across the spectrum of psychiatric diagnoses. We aimed to estimate absolute risks for self-harm and interpersonal violence post-discharge according to gender and diagnostic category. Methods Danish national registry data were utilized to investigate 62,922 discharged inpatients, born 1967–2000. An age and gender matched cohort study was conducted to examine risks for self-harm and interpersonal violence at 1 year and at 10 years post-discharge. Absolute risks were estimated as cumulative incidence percentage values. Results Patients diagnosed with substance misuse disorders were at especially elevated risk, with the absolute risks for either self-harm or interpersonal violence being 15.6% (95% CI 14.9, 16.3%) of males and 16.8% (15.6, 18.1%) of females at 1 year post-discharge, rising to 45.7% (44.5, 46.8%) and 39.0% (37.1, 40.8%), respectively, within 10 years. Diagnoses of personality disorders and early onset behavioral and emotional disorders were also associated with particularly high absolute risks, whilst risks linked with schizophrenia and related disorders, mood disorders, and anxiety/somatoform disorders, were considerably lower. Conclusions Patients diagnosed with substance misuse disorders, personality disorders and early onset behavioral and emotional disorders are at especially high risk for internally and externally directed violence. It is crucial, however, that these already marginalized individuals are not further stigmatized. Enhanced care at discharge and during the challenging transition back to life in the community is needed. Discharge from inpatient care interpersonal violence psychiatric illness self-harm substance misuse Psychiatry F. Walter verfasserin aut M. J. Carr verfasserin aut S. Antonsen verfasserin aut N. Kapur verfasserin aut S. Steeg verfasserin aut J. Shaw verfasserin aut C. B. Pedersen verfasserin aut R. T. Webb verfasserin aut In European Psychiatry Cambridge University Press, 2020 66(2023) (DE-627)320445070 (DE-600)2005377-0 17783585 nnns volume:66 year:2023 https://doi.org/10.1192/j.eurpsy.2022.2352 kostenfrei https://doaj.org/article/b1bf27196bad4a498ca0f840793a222b kostenfrei https://www.cambridge.org/core/product/identifier/S0924933822023525/type/journal_article kostenfrei https://doaj.org/toc/0924-9338 Journal toc kostenfrei https://doaj.org/toc/1778-3585 Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_217 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_374 GBV_ILN_602 GBV_ILN_636 GBV_ILN_2004 GBV_ILN_2014 GBV_ILN_2110 GBV_ILN_2336 GBV_ILN_2470 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 66 2023
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topic_facet	Discharge from inpatient care interpersonal violence psychiatric illness self-harm substance misuse Psychiatry
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authorswithroles_txt_mv	P. L. H. Mok @@aut@@ F. Walter @@aut@@ M. J. Carr @@aut@@ S. Antonsen @@aut@@ N. Kapur @@aut@@ S. Steeg @@aut@@ J. Shaw @@aut@@ C. B. Pedersen @@aut@@ R. T. Webb @@aut@@
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topic_title	RC435-571 Absolute risks of self-harm and interpersonal violence by diagnostic category following first discharge from inpatient psychiatric care Discharge from inpatient care interpersonal violence psychiatric illness self-harm substance misuse
topic	misc RC435-571 misc Discharge from inpatient care misc interpersonal violence misc psychiatric illness misc self-harm misc substance misuse misc Psychiatry
topic_unstemmed	misc RC435-571 misc Discharge from inpatient care misc interpersonal violence misc psychiatric illness misc self-harm misc substance misuse misc Psychiatry
topic_browse	misc RC435-571 misc Discharge from inpatient care misc interpersonal violence misc psychiatric illness misc self-harm misc substance misuse misc Psychiatry
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title	Absolute risks of self-harm and interpersonal violence by diagnostic category following first discharge from inpatient psychiatric care
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title_full	Absolute risks of self-harm and interpersonal violence by diagnostic category following first discharge from inpatient psychiatric care
author_sort	P. L. H. Mok
journal	European Psychiatry
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author_browse	P. L. H. Mok F. Walter M. J. Carr S. Antonsen N. Kapur S. Steeg J. Shaw C. B. Pedersen R. T. Webb
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doi_str_mv	10.1192/j.eurpsy.2022.2352
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title_sort	absolute risks of self-harm and interpersonal violence by diagnostic category following first discharge from inpatient psychiatric care
callnumber	RC435-571
title_auth	Absolute risks of self-harm and interpersonal violence by diagnostic category following first discharge from inpatient psychiatric care
abstract	Abstract Background Persons discharged from inpatient psychiatric services are at greatly elevated risk of harming themselves or inflicting violence on others, but no studies have reported gender-specific absolute risks for these two outcomes across the spectrum of psychiatric diagnoses. We aimed to estimate absolute risks for self-harm and interpersonal violence post-discharge according to gender and diagnostic category. Methods Danish national registry data were utilized to investigate 62,922 discharged inpatients, born 1967–2000. An age and gender matched cohort study was conducted to examine risks for self-harm and interpersonal violence at 1 year and at 10 years post-discharge. Absolute risks were estimated as cumulative incidence percentage values. Results Patients diagnosed with substance misuse disorders were at especially elevated risk, with the absolute risks for either self-harm or interpersonal violence being 15.6% (95% CI 14.9, 16.3%) of males and 16.8% (15.6, 18.1%) of females at 1 year post-discharge, rising to 45.7% (44.5, 46.8%) and 39.0% (37.1, 40.8%), respectively, within 10 years. Diagnoses of personality disorders and early onset behavioral and emotional disorders were also associated with particularly high absolute risks, whilst risks linked with schizophrenia and related disorders, mood disorders, and anxiety/somatoform disorders, were considerably lower. Conclusions Patients diagnosed with substance misuse disorders, personality disorders and early onset behavioral and emotional disorders are at especially high risk for internally and externally directed violence. It is crucial, however, that these already marginalized individuals are not further stigmatized. Enhanced care at discharge and during the challenging transition back to life in the community is needed.
abstractGer	Abstract Background Persons discharged from inpatient psychiatric services are at greatly elevated risk of harming themselves or inflicting violence on others, but no studies have reported gender-specific absolute risks for these two outcomes across the spectrum of psychiatric diagnoses. We aimed to estimate absolute risks for self-harm and interpersonal violence post-discharge according to gender and diagnostic category. Methods Danish national registry data were utilized to investigate 62,922 discharged inpatients, born 1967–2000. An age and gender matched cohort study was conducted to examine risks for self-harm and interpersonal violence at 1 year and at 10 years post-discharge. Absolute risks were estimated as cumulative incidence percentage values. Results Patients diagnosed with substance misuse disorders were at especially elevated risk, with the absolute risks for either self-harm or interpersonal violence being 15.6% (95% CI 14.9, 16.3%) of males and 16.8% (15.6, 18.1%) of females at 1 year post-discharge, rising to 45.7% (44.5, 46.8%) and 39.0% (37.1, 40.8%), respectively, within 10 years. Diagnoses of personality disorders and early onset behavioral and emotional disorders were also associated with particularly high absolute risks, whilst risks linked with schizophrenia and related disorders, mood disorders, and anxiety/somatoform disorders, were considerably lower. Conclusions Patients diagnosed with substance misuse disorders, personality disorders and early onset behavioral and emotional disorders are at especially high risk for internally and externally directed violence. It is crucial, however, that these already marginalized individuals are not further stigmatized. Enhanced care at discharge and during the challenging transition back to life in the community is needed.
abstract_unstemmed	Abstract Background Persons discharged from inpatient psychiatric services are at greatly elevated risk of harming themselves or inflicting violence on others, but no studies have reported gender-specific absolute risks for these two outcomes across the spectrum of psychiatric diagnoses. We aimed to estimate absolute risks for self-harm and interpersonal violence post-discharge according to gender and diagnostic category. Methods Danish national registry data were utilized to investigate 62,922 discharged inpatients, born 1967–2000. An age and gender matched cohort study was conducted to examine risks for self-harm and interpersonal violence at 1 year and at 10 years post-discharge. Absolute risks were estimated as cumulative incidence percentage values. Results Patients diagnosed with substance misuse disorders were at especially elevated risk, with the absolute risks for either self-harm or interpersonal violence being 15.6% (95% CI 14.9, 16.3%) of males and 16.8% (15.6, 18.1%) of females at 1 year post-discharge, rising to 45.7% (44.5, 46.8%) and 39.0% (37.1, 40.8%), respectively, within 10 years. Diagnoses of personality disorders and early onset behavioral and emotional disorders were also associated with particularly high absolute risks, whilst risks linked with schizophrenia and related disorders, mood disorders, and anxiety/somatoform disorders, were considerably lower. Conclusions Patients diagnosed with substance misuse disorders, personality disorders and early onset behavioral and emotional disorders are at especially high risk for internally and externally directed violence. It is crucial, however, that these already marginalized individuals are not further stigmatized. Enhanced care at discharge and during the challenging transition back to life in the community is needed.
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title_short	Absolute risks of self-harm and interpersonal violence by diagnostic category following first discharge from inpatient psychiatric care
url	https://doi.org/10.1192/j.eurpsy.2022.2352 https://doaj.org/article/b1bf27196bad4a498ca0f840793a222b https://www.cambridge.org/core/product/identifier/S0924933822023525/type/journal_article https://doaj.org/toc/0924-9338 https://doaj.org/toc/1778-3585
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author2	F. Walter M. J. Carr S. Antonsen N. Kapur S. Steeg J. Shaw C. B. Pedersen R. T. Webb
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up_date	2024-07-03T15:54:01.302Z
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