Authors:
Prof. Dr. Maja Drobnič Radobuljac | University Psychiatric Hospital Ljubljana | Slovenia
Živa Žerjav | University of Ljubljana | Slovenia
Dr. Barbara Šegula Škoberne | University Psychiatric Hospital Ljubljana | Slovenia
Introduction: Unit for Adolescent Psychiatry is the only open general adolescent psychiatric department in Slovenia. As an 18-bed unit it admits patients with various types of psychopathology (from early-onset schizophrenia, developmental disorders, emotional disorders, to substance use and emerging personality disorders) and various levels of risk (from no risk of harm to self or others to acute suicidality or active non-suicidal self-injurious behavior (NSSI)) for diagnostic evaluation and treatment. The main treatment method is psychopharmacotherapy together with group- and individual-based psychodynamic psychotherapy, coupled with various other therapeutic modalities (psychodrama, occupational, art and social skills therapies, hospital school). The aim of the present study was to assess the differences between the admitted patients with and without NSSI and propose differential management programs accordingly.
Subjects and methods: Retrospective chart review was performed with the patients admitted to adolescent psychiatric unit from December 2015 to December 2016 extracting data on gender, duration of hospitalization, actual or past NSSI, suicidal behavior, admission and discharge SDQ (patient version), cGAS scores and ICD-10 diagnoses.
Results: In the one-year period 108 patients were admitted (73 females, 35 males), their average age was 16.9 years (SD 1.5), 95 patients filled out the SDQ on admission and 58 at discharge. Fifty patients (46.3%) ever engaged in NSSI, in 27 of these (54%) NSSI was present at admission. The patients with NSSI were on average younger (16.5 years vs 17.2 years, p<.05), more frequently female (86.0% vs 51.7%, p<.0001), had more frequent suicidal ideation (43.1% vs 72.0%, p<.005), history of attempted suicide (32.0% vs 7.0%, p<.005), and less favorable admission SDQ scores on overall stress (18.4 vs 15.3, p<.05), emotional distress (6.2 vs 5.2, p=.05), behavioral difficulties (2.4 vs 1.6, p<.01), kind and helpful behavior (7.1 vs 8.1, p.01), any disorder (1.3 vs 0.9, p<.05) and emotional disorder (1.2 vs 0.7, p<.05). There was a trend towards lower scores on all other SDQ scales, admission cGAS scores and the length of hospitalization for patients with NSSI, although these were not statistically significant.
Discussion: The data show higher levels of psychopathology in the group of patients with NSSI, who require specific levels of care and specific treatment methods.