Mental health disorders, functioning and health-related quality of life among extensively hospitalized patients due to severe self-harm – results from the Extreme Challenges project

• Main Authors: Langjord, Tuva, Pedersen, Geir Arild Feigum, Bovim, Tone, Christensen, Tore Buer, Eikenæs, Ingeborg Helene Ulltveit-Moe, Hove, Oddbjørn, Kildahl, Arvid Nikolai, Mork, Erlend, Norheim, Astrid Berge, Ramleth, Ruth-Kari, Ringen, Petter Andreas, Romm, Kristin Lie, Siqveland, Johan, Schønning, Thea, Stänicke, Line Indrevoll, Torgersen, Terje, Pettersen, Mona, Tveit, Tone, Urnes, Øyvind, Walby, Fredrik A, Kvarstein, Elfrida Hartveit
• Format: Article
• Language: English

Background: Severe self-harm leading to extensive hospitalization generates extreme challenges for patients, families, and health services. Controversies regarding diagnoses and health care often follow. Most evidence-based treatments targeting self-harm are designed for borderline personality disorder (BPD). However, current knowledge about mental health status among individuals with severe self-harm is limited. Objectives: To investigate psychopathology among patients extensively hospitalized due to severe or frequent self-harming behaviors. Method: A cross sectional study (period 2019–2021) targeting psychiatric inpatients (>18 years) with frequent (>5) or long (>4 weeks) admissions last year due to self-harm. The target sample (N = 42, from 12 hospitals across all Norwegian health regions) was compared to individuals admitted to outpatient personality disorder (PD) treatment within specialist mental health services in the same period (N = 389). Clinicians performed interviews on self-harm and psychopathology, supplemented by self-report. Results: The target sample were young adults, mainly female, with considerable hospitalization and self-harming behaviors, both significantly more extensive than the comparison group. The majority in both groups reported self-harm onset