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Violence and self-harm in severe mental illness: inpatient study of associations with ethnicity, cannabis and alcohol

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Summary:

This analysis involved 141 adult psychiatric inpatients in Hamilton, New Zealand, 66% of whom had a history of violence, 54% a history of self-harm, and 40% had a history of both; only 20% had neither. Cannabis use was a significant predictor of lifetime violence (p=0.02); no such association was seen between violence and gender, age, ethnicity, alcohol use, or psychiatric diagnosis. Self-harm was predicted by female gender (p<0.001), by cannabis use (p=0.025) and alcohol use (p=0.036); age, ethnicity and diagnosis did not reach significance. Fewer than 10% of patients were receiving treatment for substance use comorbidity.

Comment:
I wish to thank readers who sent papers through to me. David Menke’s paper showed significant associations of violence and self-harm with histories of substance abuse in the severely mentally ill. Interestingly, Māori ethnicity did not play a significant role, which is important, as it points to upstream/root causes for current inequities between Māori and non-Māori.
Reference: Australas Psychiatry. 2017;25(1):28-31
Independent commentary by Dr. Matire Hardwood

Dr Matire Harwood (Ngapuhi) has worked in Hauora Māori, primary health and rehabilitation settings as clinician and researcher since graduating from Auckland Medical School in 1994. She also holds positions on a number of boards, committees and advisory groups including the Health Research Council. Matire lives in Auckland with her whānau including partner Haunui and two young children Te Rangiura and Waimarie.

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Disclaimer: This publication is not intended as a replacement for regular medical education but to assist in the process. The reviews are a summarised interpretation of the published study and reflect the opinion of the writer rather than those of the research group or scientific journal. It is suggested readers review the full trial data before forming a final conclusion on its merits.

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