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Depression in deliberate self harm patients

M S Mullick1, M E Karim, M Khanam

  • 1Institute of Mental Health and Research, Dhaka.

Bangladesh Medical Research Council Bulletin
|December 1, 1994
PubMed
Summary
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Many deliberate self-harm patients suffer from undiagnosed major depressive disorder (MDE) and depressive symptoms. This highlights a critical gap in mental health awareness and hospital referral services for these individuals.

Area of Science:

  • Psychiatry
  • Mental Health
  • Public Health

Background:

  • Deliberate self-harm (DSH) is a significant public health concern.
  • A substantial number of individuals engaging in DSH may have underlying mental health conditions, particularly depression.
  • Identifying and addressing these conditions is crucial for effective intervention and prevention.

Purpose of the Study:

  • To investigate the prevalence of Major Depressive Episode (MDE) and depressive symptoms among patients admitted for deliberate self-harm.
  • To assess the consistency of diagnostic criteria (DSM III-R) and severity scoring (HRSD) for depression in this population.
  • To evaluate the current psychiatric treatment and awareness levels regarding depression in DSH patients.

Main Methods:

  • A consecutive sample of 100 deliberate self-harm patients was assessed.

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  • Diagnostic and Statistical Manual of Mental Disorders, Third Edition, Revised (DSM III-R) criteria were used to diagnose Major Depressive Episode (MDE).
  • Hamilton Rating Scale for Depression (HRSD) scores were utilized to grade depression severity.

    • Main Results:

    • 38% of DSH patients met DSM III-R criteria for Major Depressive Episode (MDE), with most cases being severe or moderate.
    • An additional 48% exhibited depressive symptoms, potentially linked to extreme subjective distress.
    • Only 5% of depressed DSH patients were receiving psychiatric treatment, indicating low awareness and poor hospital referral services.

    Conclusions:

    • Major depressive disorder and depressive symptoms are highly prevalent in deliberate self-harm patients.
    • There is a significant lack of awareness and inadequate psychiatric referral services for depression among DSH patients within hospital settings.
    • Urgent improvements in screening, diagnosis, and treatment pathways are necessary for this vulnerable population.