Detailed contribution information
| Contribution title | 3495 - Adolescent self cutting in the Emergency Room: an overview in the Pediatric Italian Hospital of Padua |
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| Contribution code | PS02-38 (P) |
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| Form of presentation | Poster |
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| Abstract |
Objectives Non Suicidal Self Injurious Behaviors (NSSI) affect up to 45% of adolescents, representing a global health priority (Nock, 2010; Ougrin, 2014). The most common of them is self-cutting, although the actual incidence is unknown. This behavior is characterized by high risk of repetition and it is an independent strong risk factor for suicide (Hawton et al., 2012). Detection of NSSI and particularly of self-cutting is often accidental and it is estimated that only 1 to 8 patients comes to clinical attention (Madge et al., 2008). The aim of the study is to analyze psychopathological characteristics of pediatric patients with self-cutting admitted to the Emergency Room (ER) of the Department of WCH of Padua, in order to improve the care and the prevention of self-harm behavior. Methods: The clinical charts of all pediatric patient presented with self-cutting to the ER during the last 5 years and followed at the Psychiatric Unit of the Department of WCH of Padua were reviewed (n=61). Each subject was valuated through a complete psychodiagnostic assessment (free talks, standardized and projective tests). Self-cutting was classified in occasional and repetitive (≥5 episodes/year) according to DSM-5. Different body sites involvement in self-cutting was considered an index of severity. Results: Patients admitted to the ER with self cutting, aged 11-17 years old (M=14.23), were mainly female (82%). The main diagnoses were affective disorders (72.1%), anxiety disorders (9.8%) and behavioural disorders (8.2%). Most of the patients required pharmacological treatment (74%), especially with quetiapine (49%) and olanzapine (24%). Self-cutting involving multiple body areas resulted associated with the presence of suicidal ideation, suicide attempt and more frequent self-cutting behaviors. Moreover the presence of suicidal ideation significantly correlated with the choice to adopt pharmacological treatment. Conclusions: Although the wide spreading of self-cutting could lead to a normalization of these behaviors, even a single episode of self-harm should not be underestimated by mental health specialists. The present results could not identify a homogeneous psychopathological risk profile of patients admitted to ER to prevent the acting out. Anyway, the repetition and the involvement of several body parts were associated to a worse clinical severity. Further studies are needed in order to better understand risk and protective factors involved in self-cutting. |