OBJECTIVES: This study aims to describe the trends of psychiatric referrals for international self-harm from January 2005 until December 2009.
METHODOLOGY: A retrospective descriptive study using chart review of all patients with ICD code X60-X84 during the 5 year study period was done. Demographic data of all subjects and the psychiatric diagnoses of those referred were obtained. The distribution of referral status according to patient profile was likewise described.
RESULTS: There were 195 charts reviewed wherein the ff data was gathered:66% were female, 59% were less than 30 years old, 64% were single, 84% were Catholics, while 31% were students and 28% were unemployed. Fifty seven percent had no medical illness and 78% had no known psychiatric illness. Of the 35 who were diagnosed to have a psychiatric illlness (35/195=18%), most (49% were depressed while 17% had bipolar disorder. Eighty percent had a stressor prior to self harm and 51% had intention of killing self. One third (36%) had no previous episode of intentional self harm while 33% did have a previous episode. With regards method of self harm, 89% ingested either drugs (129/195=66%) or chemicals (44/195=23%). Seventy seven percent were admitted by internal medicine, 82% had a hospital stay of 3 days or less and 81% were discharged improved. When comparing the frequency trends of psychiatric referrals for intentional self harm from 2005-2009, the highest rate of referrals were in 2009 at 68% while the lowest rate of referring patients to psychiatry was in 2006 at 26%. Referral was higher among those with co morbid medical illness but also had the higher refusal rate. Non-referral was higher among those without co-morbid medical illness. Referral was highest among those who had known psychiatric illnesses. Those whose psychiatric conditions were not stated had the highest non-referrals and refusal rates. Referral rates were highest among patients who were admitted under the OB-Gynecology, ENT and Anesthesiology departments while non-referral was highest among those admitted under pediatrics department.
CONCLUSIONS: Majority of patients were referred but there were no noted trend when annual percentages of psychiatric referral were compared. Non-referral was consistently greater than refusal in 2005-08 but reversed in 2009.