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Predictive properties of risk assessment instruments following self-harm

  • David Owens (a1) and Rachael Kelley (a2)
Summary

This month's BJPsych publishes two important studies concerned with the use of risk assessment scales after self-harm, one a systematic review and the other a multicentre cohort study. We agree with the authors: that each study adds weight to the existing evidence that points towards avoiding the use of such scales in clinical practice.

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Copyright
Corresponding author
David Owens, Leeds Institute of Health Sciences, Worsley Building, Clarendon Way, Leeds LS2 9NL, UK. Email: d.w.owens@leeds.ac.uk
Footnotes
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See pp. 387–395 and 429–436, this issue.

Declaration of interest

None.

Footnotes
References
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1 Mulder, R, Newton-Howes, G, Coid, JW. The futility of risk prediction in psychiatry. Br J Psychiatry 2016; 209: 271–2.
2 Chan, MKY, Bhatti, H, Meader, N, Stockton, S, Evans, J, O'Connor, RC, et al. Predicting suicide following self-harm: systematic review of risk factors and risk scales. Br J Psychiatry 2016; 209: 277–83.
3 Quinlivan, L, Cooper, J, Meehan, D, Longson, D, Potokar, J, Hulme, T, et al. Predictive accuracy of risk scales following self-harm: multicentre, prospective cohort study. Br J Psychiatry 2017; 210: 429–36.
4 Carter, G, Milner, A, McGill, K, Pirkis, J, Kapur, N, Spittal, MJ. Predicting suicidal behaviours using clinical instruments: systematic review and meta-analysis of positive predictive values for risk scales. Br J Psychiatry 2017; 210: 387–95.
5 Sackett, DL, Haynes, RB. The architecture of diagnostic research. BMJ 2002; 324: 539–41.
6 National Institute of Health and Care Excellence. Self-Harm. The NICE Guideline on Longer-term management. National Clinical Guideline Number 133. British Psychological Society & Royal College of Psychiatrists, 2011.
7 Bolton, JM, Gunnell, D, Turecki, G. Suicide risk assessment and intervention in people with mental illness. BMJ 2015; 351: h4978.
8 Horrocks, J, Hughes, J, Martin, C, House, A, Owens, D. Patient Experiences of Hospital Care Following Self-harm – A Qualitative Study. University of Leeds, 2005.
9 Taylor, TL, Hawton, K, Fortune, S, Kapur, N. Attitudes towards clinical services among people who self-harm: systematic review. Br J Psychiatry 2009; 194: 104–10.
10 Palmer, L, Blackwell, H, Strevens, P. Service Users' Experiences of Emergency Services Following Self-Harm: A National Survey of 509 Patients. CCQI, Royal College of Psychiatrists, 2007.
11 Owens, C, Hansford, L, Sharkey, S, Ford, T. Needs and fears of young people presenting at accident and emergency department following an act of self-harm: secondary analysis of qualitative data. Br J Psychiatry 2016; 208: 286–91.
12 Hunter, C, Chantler, K, Kapur, N, Cooper, J. Service user perspectives on psychosocial assessment following self-harm and its impact on further help-seeking: a qualitative study. J Affect Disord 2013; 145: 315–23.
13 Cooper, J, Steeg, S, Bennewith, O, Lowe, M, Gunnell, D, House, A, et al. Are hospital services for self-harm getting better? An observational study examining management, service provision and temporal trends in England. BMJ Open 2013; 3: e003444.
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The British Journal of Psychiatry
  • ISSN: 0007-1250
  • EISSN: 1472-1465
  • URL: /core/journals/the-british-journal-of-psychiatry
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Predictive properties of risk assessment instruments following self-harm

  • David Owens (a1) and Rachael Kelley (a2)
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