Extreme Challenges - Psychopathology & Treatment Experiences Among Severly Selfharming Inpatients in Norway

Summary

Patients who self-harm are a heterogeneous population. Outpatient treatments structured for borderline personality disorder are often recommended and hospitalization kept to a minimum. However, few studies have focused on the most severe, complex conditions with extreme suicide risk. A recent national investigation from Norway (2017) demonstrated a far larger cohort of extensively hospitalized inpatients with extreme self-harming behaviors than was expected (N=427) - identified in all health regions. Reported challenges were high-risk situations, severe medical sequelae, difficult collaborations across services, and uncertainty about psychiatric diagnoses.

Severe, often bizarre, self-harm is thus a major challenge for both patients and health services. In hospitals, safety measures can involve restrictions and involuntary regimes. As research on this target population is sparse, the current project seeks further understanding of complex conditions - psychopathology, treatment experiences and service collaboration.

The project is a national, multi-center cooperation including patients in psychiatric hospitals in all health regions. It is cross sectional. Data is based on diagnostic interviews, patients' self-reported symptoms and both patients and service providers treatment experiences. The inclusion period for inpatients (N=300) and a comparison sample of outpatients (N=300) is one year.

The target group is inpatients with extreme hospitalization and severe self-mutilation. A comparison group is patients with personality pathology attending outpatient treatments. Recruitment is across health regions.

Aim 1: Investigate psychopathology of patients in the target population and compare to a clinical sample admitted to outpatient treatment

Aim 2: Investigate personality functioning in the target population and compare to a clinical sample admitted to outpatient treatment

Aim 3: a) Investigate health service use in the target population and compare to a clinical sample admitted to outpatient treatment.

b) Investigate treatment experiences and health service collaborations in the target population.

The project will provide rational for future preventive treatment interventions

Conditions

• Self Harm
• Personality Disorders
• Psychosis
• Developmental Disorder
• PTSD
• Cognitive Impairment

Interventions

OTHER

Assessment of diagnoses, functioning and health services

Systematic differential diagnostics, assessment of psychosocial and personality functioning and treatment/ health services

Sponsors & Collaborators

• Extrastiftelsen

  collaborator OTHER

• National Advisory Unit for Personality Psychiatry (NAPP)

  collaborator UNKNOWN

• Research Group Personality Psychiatry

  collaborator UNKNOWN

• Network for personality-focused treatment

  collaborator UNKNOWN

• National Centre for Suicide Research and Prevention (NSSF)

  collaborator UNKNOWN

• Regional Centre for Violence and Traumatic Stress (RVTS)

  collaborator UNKNOWN

• Regional Centre for Early Intervention Psychosis (TIPS SØrØst)

  collaborator UNKNOWN

• Regional collaborators and users

  collaborator UNKNOWN

• Oslo University Hospital

  lead OTHER

Principal Investigators

• Elfrida H Kvarstein, MD,PhD · Oslo University Hospital

Eligibility

Min Age

18 Years

Max Age

60 Years

Sex

ALL

Healthy Volunteers

No

Timeline & Regulatory

Start

2019-10-01

Primary Completion

2021-09-01

Completion

2021-09-01

Countries

• Norway

Study Locations