Self-harm on a specialist adult eating disorder unit: a retrospective cohort study of patient characteristics and outcomes
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Leah Holm-Mercer, Douglas Kohler and Agnes Ayton. Self-harm on a specialist adult eating disorder unit: a retrospective cohort study of patient characteristics and outcomes. BJPsych Open; London Vol. 7, Iss. S1, (Jun 2021)
Deliberate self-harm (DSH) is common but rarely studied among inpatients with eating disorders. We sought to investigate the frequency of DSH among inpatients in a specialist adult eating disorders unit, and the association of DSH with comorbidities and treatment outcomes. We also investigated changes in these parameters during the pandemic. Self-harm during admission was seen in 29% of patients and was associated with the presence of comorbid psychiatric diagnoses. The frequency of DSH much reduced between admission and discharge, suggesting a beneficial effect of treatment. Medical transfer for DSH, considered as a proxy measure for severity, predicted poorer outcomes in weight restoration. We also noted an increase in rates of DSH during the pandemic, which may have resulted from a combination of increased psychosocial stressors and a reduction in admission capacity in eating disorder units.
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