مشکلات گزارش شده توسط بیماران خوداسیبی: ادراک، ناامیدی، و قصد خودکشی

Objective: Research suggests that problem-solving therapy may be an effective intervention following self-harm. This study determines the relation between self-harm patients' perceptions of their problems and their expressions of hopelessness and suicidal intent. Method: One hundred fifty patients admitted to a district hospital following self-harm were asked questions about the type and perceived solubility of their problems. In addition, in each case, the patient completed a Beck's hopelessness scale and a psychiatrist completed a Beck's suicidal intent scale. Results 66% of patients, and more of the males than of the females, recorded at least one problem that they believed to be insoluble; such problems were most often in the area of relationships. Patients who reported insoluble problems experienced higher levels of hopelessness and more suicidal intent. There was significant correlation among the number of insoluble problems, hopelessness, and suicidal intent. Conclusions: People who undertake self-harm report insoluble relationship problems. When assessing hopelessness and suicidal intent in self-harm patients, clinicians should ask about perception of insoluble problems.

Recent rates of self-harm in the UK are higher than ever before [1]. As many as one in six self-harm patients repeats within a year [2] and this proportion may be increasing [1]. In the year following nonfatal self-harm, the best estimate of the suicide rate is a hundred times that of the general population [3] but evidence about which interventions might reduce that risk is disconcertingly poor [4]. People who harm themselves describe problems in their lives [5] and report hopelessness [6] and [7]. Problem-solving therapies [2] and interpersonal therapy, focussing on interpersonal problems [8], have been identified as the most promising interventions. The present study determines the number, type, and solubility of problems in a sample of people admitted to hospital following self-harm—to identify their relation to suicidal intent and hopelessness.