Impulsive behaviors in female patients with eating disorders in a university hospital in northern Taiwan

Eating disorders (EDs) are often associated with various impulsive behaviors. This study investigated the prevalence of impulsive behaviors in ED patients in Taiwan. Three hundred sixteen female outpatients with ED and 142 psychiatric controls were recruited. All participants completed self-administered questionnaires assessing lifetime presence of impulsive behaviors, including suicide, self-injury, stealing, alcohol use, illicit drug use, excessive spending, sexual promiscuity, and general psychopathology. More than 60% of the ED patients had at least one impulsive behavior. The most common impulsive behaviors among ED patients were excessive spending (34.9%), deliberate self-harm (32.7%), and stealing (26.3%). However, there were no significant differences in prevalences of any impulsive behaviors between ED patients and psychiatric controls. Clinicians should routinely assess and treat impulsive behaviors in female psychiatric patients with negative affectivity, regardless of the presence of ED, to help prevent potential adverse outcomes related to impulsive behaviors.     

Use of a think-aloud procedure to explore the relationship between clinical reasoning and solution-focused training in self-harm for emergency nurses

Self-harm is a risk factor for further episodes of self-harm and suicide. The most common service used by self-injurers is the emergency department. However, very often, nurses have received no special training to identify and address the needs of these patients. In addition this care context is typically biomedical and without psychosocial skills, nurses can tend to feel unprepared and lacking in confidence, particularly on the issue of self-harm. In a study that aimed to improve understanding and teach solution-focused skills to emergency nurses so that they may be more helpful with patients who self-harm, several outcome measures were considered, including knowledge, professional identity and clinical reasoning. The think-aloud procedure was used as a way of exploring and improving the solution-focused nature of nurses' clinical reasoning in a range of self-harm scenarios. A total of 28 emergency nurses completed the activity. Data were audiotaped, transcribed and analysed. The results indicated that significant improvements were noted in nurses' ability to consider the patients' psychosocial needs following the intervention. Thus this study has shown that interactive education not only improves attitude and confidence but enlarges nurses' reasoning skills to include psychosocial needs. This is likely to improve the quality of care provided to patients with mental health problems who present to emergency settings, reducing stigma for patients and providing the important first steps to enduring change – acknowledgment and respect.     

Management of Laryngotracheal Trauma During the COVID 19 Pandemic: Our Experience

Objective To study the outcomes in terms of airway, voice and swallowing as well as the economic impact of the trauma on patients’ finances and the constrained health infrastructure due to the pandemic. Materials and methods Study design Retrospective study. Setting: Tertiary care teaching hospital. Subjects and methods: A retrospective study was done of the 19 subjects who sustained acute laryngotracheal trauma during the SARS CoV-2 pandemic and was managed at our institution from January 2020 to September 2021.Results Change in voice was the most common presenting symptom and thyroid cartilage fractures were the commonest cartilage injury noted. It was found that 93% (decannulated) of the patients had good functional outcome and 90% of them required financial support to meet the medical expenses.Conclusion During the COVID 19 pandemic, it was not only, early presentation, timely detection and intervention by the treating team, but also the multidisciplinary teamwork and the support system that facilitated the recuperation and restoration of these traumatized individuals back into society with good laryngeal function.     

The impact of screen media portrayals of suicide on viewers: A rapid review of the evidence

This rapid review aimed to review recent published literature and describe the current evidence regarding the impact, on viewers, of portrayals of suicide in screen/ moving-image fiction and non-fiction media, such as television/web series, films and documentaries. We searched various databases for research conducted within the past decade (2009–2019). A total of 16 articles were eligible for inclusion. The literature reported varying impacts of portrayals of suicide through moving-image media such as increased suicidal ideation and behaviour, as well as positive impacts such as increased help-seeking behaviour. While there is limited evidence which focuses specifically on the impact of moving-image media, the studies included in this review highlight concerning trends regarding the impact of media portraying deaths by suicide on subsequent suicidality. However, positive impacts on suicide awareness, literacy and help-seeking behaviour were also identified.     

Survivors of deliberate self-harm attempt in the military milieu: An exploratory study of psychiatric morbidity and psychosocial correlates

BackgroundDeliberate self-harm (DSH) is common in modern society. A million people worldwide die from suicide each year, leading to a large toll on human resources and economy. Research has revealed DSH as an important indicator of eventual suicide worldwide. The present study focused on DSH attempters among Armed Forces personnel and family members with the aim of identifying modifiable factors to provide recommendations for primary prevention in the military milieu.MethodsHundred cases of survivors of DSH were evaluated in a case–control study using psychiatry assessment instruments (the Mini-International Neuropsychiatric Interview, Pierce Suicide Intent Scale, Hamilton's Depression and Anxiety Scales and presumptive life event scale) to assess psychiatric morbidity and psychosocial correlates. The findings were compared with those of 100 healthy matched controls. The data were analysed using SPSS software.ResultThe majority of DSH survivors (98%) had concurrent psychiatric morbidity, major depressive disorder (23%) being the commonest diagnosis followed by psychotic disorder and alcohol use disorder. Presence of relationship problems (69%) and financial difficulties (19%) were significant triggering factors in our study. Many DSH attempters had voiced suicidal ideation (66%) before their act and had history of aggression or violence (76%) in the past.ConclusionOur findings are discussed in relation with findings in the literature. Recommendations regarding awareness campaign, specific skill development programs and the need for early intervention in individuals with psychiatric morbidity have been proposed to prevent such behaviours.     

An Empirical Analysis of Internet Message Boards for Self-Harming Behavior

Much debate surrounds the potential effects of self-harm forum use. Arguments in favor highlight factors such as providing access to a supportive community. However critical voice highlighting potential dangers such as forums serving as a platform to promote self-harm, clearly dominate the debate. Using an online questionnaire, the goal of the current study was to examine sociodemographic characteristics, the psychopathology of forum users, motives for participating, and subjective effects of self-harm forum use. A total of 309 self-harm forum users participated in this study. 3 heterogeneous user types with differing motives for visiting the forum and different usage effects were identified. The results question the assumptions that self-harm forums are a source of harm and point to their predominantly constructive and preventive functions.