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Tijdschrift voor Psychiatrie 63 (2021) 6, 419 - 424


Self-harming behavior by patients admitted to forensic psychiatry

V. de Vogel, N. Verstegen

Background Incidents of self-harm by forensic psychiatric patients usually have a large impact on all those involved and self-harming behavior is an important predictor for violence towards others during treatment.
Aim To describe incidents of self-harm during the treatment of patients admitted to forensic psychiatry.
Method All incidents of self-harm during treatment in a forensic psychiatric center that were registered between 2008 and 2019 were analyzed and coded with respect to severity with the MOAS+.
Results Between 2008 and 2019 299 incidents of self-harm were registered committed by 106 patients. Most of these incidents (87,6%) were classified as non-suicidal. Methods most often used were cutting themselves with glass, broken plates or mugs, a razor or knife and swallowing dangerous objects or liquids. There were ten cases of suicide, almost all by suffocation with a rope or belt. The majority of the incidents were coded as severe or extreme with the MOAS+. Female patients were overrepresented and they caused on average three times more incidents than male patients.
Conclusion Incidents of self-harm happen regularly in forensic psychiatry and are usually severe. More research is needed into the impact on all those involved, motivations and triggers for self-harming behavior and effective treatment of it.