Abstract
The assessment of self-harm risk is a common, difficult, and perplexing task for many physicians, especially those working in emergency departments (ED). Attempts have been made to determine objective methods for assessing patients with suicidal ideation or self-harm though there is still a lack of knowledge about objective assessments of these patients. A study was conducted where 181 suicidal patients were enrolled in two EDs within the city of Edmonton, Canada. Initial interviews were conducted in the ED which collected basic demographics and medical history as well as psychometric measures including the Beck Hopelessness Scale, Barratt Impulsiveness Scale, Brief Symptom Inventory, Drug Abuse Screening Test 10, and CAGE questionnaire. The results of these measures were compared between those who presented to the ED with self-harm and those who presented only with ideation. Those with recent self-harm scored lower on many of the scales and subscales of distress and impulsivity measured compared to those with no recent self-harm. Possible explanations for this difference include differences in psychological traits between the two groups and possible cathartic effects of self-harm. The lower scores obtained by those that present with self-harm may complicate attempts to use psychometric tools to determine future self-harm risk.
Highlights
The assessment of suicidal and self-harming patients is a common occurrence in primary care (Gaynes et al, 2004) in the emergency department (ED; Doshi et al, 2005)
Questionnaire results Those who presented with recent self-harm were compared to those without recent self-harm to determine if any significant differences existed between those two groups
The two groups differed in their Beck Hopelessness Scale scores (p = 0.012)
Summary
The assessment of suicidal and self-harming patients is a common occurrence in primary care (Gaynes et al, 2004) in the emergency department (ED; Doshi et al, 2005). There are limited data available on psychometric measures related to self-harm presentations in acute settings like the ED (Randall, Colman & Rowe, 2011). How to cite this article Randall et al (2014), Recent self-harm and psychological measures in the emergency department. These characteristics may affect the scores on these tools and confound their ability to assess the risk of future self-harm
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