CHARACTERISTICS OF PATIENTS REFERRED FROM EMERGENCY AND GENERAL WARDS TO PSYCHIATRIC SERVICES FOR DELIBERATE SELF-HARM IN BRUNEI DARUSSALAM.

Hilda HO and Ahmed SAMI

Department of Psychiatry Services, RIPAS Hospital, Ministry of Health, Brunei Darussalam.

ABSTRACT

Introduction: Deliberate self-harm (DSH) is a common presentation to hospital emergency departments and general wards in Brunei. Patients who present with DSH are usually referred for a psychiatric assessment.  Methods: This study describes the demographic, social and clinical characteristics of patients who were referred to psychiatric services after an acute incident of DSH. An evaluation of the DSH methods used and situational factors was conducted.  Outcomes included medical or surgical treatment, hospital and psychiatric admissions.  Results: Ninety-nine patients were referred between 1st October 2018 and 1st September 2020. Sixty-five (65.7%) were female. The mean age was 26.6 years. The most common method of DSH was overdose of medication, followed by self-cutting. Females were significantly more likely to overdose than males. The most common situational factors were relationship and financial problems. Previous psychiatric history and chronic medical conditions were equally prevalent in about a quarter of participants. Most participants did not require a psychiatric admission. Conclusions: Female gender, young age, unemployment, recent history of DSH, previous psychiatric history, chronic medical conditions, relationship and financial problems, were identified as risk factors for DSH. The majority of people presenting with DSH required medical intervention, however only a small proportion required psychiatric admission. Although the majority of DSH incidents were unplanned, providing interventions for these high-risk groups may be helpful. 

Keywords: Deliberate self-harm, Cross-sectional study, Demography, Drug overdose, mental health, Brunei.

Corresponding author: Dr Hilda Ho, Consultant Psychiatrist, Department of Psychiatric Services, RIPAS Hospital, Simpang 253-79, Kiarong BE1318, Brunei Darussalam.

Email: hilda.ho@moh.gov.bn 

Brunei Int Med J.2022;18:149-157