Centre for Suicide Research, Department of Psychiatry, University of Oxford, Warneford Hospital, OX29 6UP, UK; Oxford Health NHS Foundation Trust, Warneford Hospital, Oxford, OX29 6UP, UK.
Centre for Suicide Research, Department of Psychiatry, University of Oxford, Warneford Hospital, OX29 6UP, UK; Oxford Health NHS Foundation Trust, Warneford Hospital, Oxford, OX29 6UP, UK.
J Psychiatr Res. 2021 May;137:437-443. doi: 10.1016/j.jpsychires.2021.03.028. Epub 2021 Mar 18.
The COVID-19 pandemic and resulting public health measures may have major impacts on mental health, including on self-harm. We have investigated what factors related to the pandemic influenced hospital presentations following self-harm during lockdown in England.
Mental health clinicians assessing individuals aged 18 years and over presenting to hospitals in Oxford and Derby following self-harm during the period March 23rd to May 17, 2020 recorded whether the self-harm was related to the impact of COVID-19 and, if so, what specific factors were relevant. These factors were organized into a classification scheme. Information was also collected on patients' demographic characteristics, method of self-harm and suicide intent.
Of 228 patients assessed, in 46.9% (N = 107) COVID-19 and lockdown restrictions were identified as influencing self-harm. This applied more to females than males (53.5%, N = 68/127 v 38.6%, N = 39/101, χ = 5.03, p = 0.025), but there were no differences in age, methods of self-harm or suicide intent between the two groups. The most frequent COVID-related factors were mental health issues, including new and worsening disorders, and cessation or reduction of services (including absence of face-to-face support), isolation and loneliness, reduced contact with key individuals, disruption to normal routine, and entrapment. Multiple, often inter-connected COVID-related factors were identified in many patients.
COVID-related factors were identified as influences in nearly half of individuals presenting to hospitals following self-harm in the period following introduction of lockdown restrictions. Females were particularly affected. The fact that mental health problems, including issues with delivery of care, predominated has implications for organisation of services during such periods. The contribution of isolation, loneliness and sense of entrapment highlight the need for relatives, friends and neighbours to be encouraged to reach out to others, especially those living alone. The classification of COVID-related factors can be used as an aide-memoire for clinicians.
COVID-19 大流行和由此产生的公共卫生措施可能对心理健康产生重大影响，包括自残。我们研究了与大流行相关的哪些因素影响了英格兰封锁期间自残后的住院治疗。
在 2020 年 3 月 23 日至 5 月 17 日期间，牛津和德比的医院对 18 岁及以上因自残而就诊的心理健康临床医生评估，记录自残是否与 COVID-19 的影响有关，如果有，哪些具体因素相关。这些因素被组织成一个分类方案。还收集了患者的人口统计学特征、自残方法和自杀意图的信息。
在 228 名接受评估的患者中，有 46.9%（N=107）确定 COVID-19 和封锁限制是影响自残的因素。这在女性中比男性更为普遍（53.5%，N=68/127 与 38.6%，N=39/101，χ=5.03，p=0.025），但两组在年龄、自残方法或自杀意图方面没有差异。最常见的 COVID 相关因素是心理健康问题，包括新的和恶化的障碍，以及服务的停止或减少（包括缺乏面对面支持）、隔离和孤独、与关键人员的接触减少、正常常规中断和被困。许多患者中都确定了多个相互关联的 COVID 相关因素。
在引入封锁限制后，近一半在医院接受自残治疗的个体被确定为 COVID 相关因素的影响。女性受到的影响尤其大。心理健康问题，包括护理提供方面的问题占主导地位，这对这些时期服务的组织具有影响。隔离、孤独和被困感的贡献突出了需要鼓励亲戚、朋友和邻居向他人伸出援手，尤其是那些独居的人。COVID 相关因素的分类可作为临床医生的辅助记忆工具。
