Author
Else Guthrie
Other affiliations: Manchester Mental Health and Social Care Trust, University of Manchester, Manchester Royal Infirmary
Bio: Else Guthrie is an academic researcher from University of Leeds. The author has contributed to research in topics: Psychological intervention & Liaison psychiatry. The author has an hindex of 17, co-authored 41 publications receiving 1526 citations. Previous affiliations of Else Guthrie include Manchester Mental Health and Social Care Trust & University of Manchester.
Papers
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TL;DR: The results highlight the importance in a suicide prevention strategy of early intervention after an episode of self-harm, and the importance of attention to physical illness, alcohol problems, and living circumstances, in treating female patients.
Abstract: OBJECTIVE: The purposes of this study were to estimate suicide rates up to 4 years after a deliberate self-harm episode, to investigate time-period effects on the suicide rate over the follow-up period, and to examine potential sociodemographic and clinical predictors of suicide within this cohort. METHOD: This prospective cohort study included 7,968 deliberate self-harm attendees at the emergency departments of four hospital trusts in the neighboring cities of Manchester and Salford, in northwest England, between September 1, 1997, and August 31, 2001. Suicide rates and standardized mortality ratios (SMRs) for the cohort were calculated. Potential risk factors were investigated by using Cox’s proportional hazards models. RESULTS: Sixty suicides occurred in the cohort during the follow-up period. An approximately 30-fold increase in risk of suicide, compared with the general population, was observed for the whole cohort. The SMR was substantially higher for female patients than for male patients. Suicide ...
603 citations
TL;DR: There was significant impairment of health-related quality of life (SF36 scores) in cases and, to a lesser extent, in subthreshold cases compared to controls, indicating the need for future intervention studies.
148 citations
TL;DR: Application of this simple, highly sensitive rule may facilitate assessment in the ED and help to focus psychiatric resources on patients at higher risk of repetition or suicide.
113 citations
TL;DR: Young South Asian women are at high risk of self-harm, but their clinical risk appears to be lower in terms of the accepted contextual factors contributing to risk.
Abstract: BACKGROUND: Rates of self-harm appear high in South Asian young women in the United Kingdom (UK) although previous studies were mostly small. Data on treatment and outcomes for South Asians are lacking. This study compared rates of self-harm, socio-demographic and clinical characteristics, provision of services and risk of repetition by ethnicity. METHOD: A prospective cohort of adult self-harm attendees (n = 7185), aged 15 and over presenting to four emergency departments in the cities of Manchester and Salford, UK over a 4-year period. RESULTS: The study included 299 South Asians. South Asian women aged 16-24 years were more likely to self-harm than Whites of the same age group (1010.9 vs. 754 per 100,000). Across all age groups the rates of self-harm were lower in South Asian men compared to White men and to South Asian women. South Asian women were significantly more likely to report relationship problems within the family than White women (32% vs. 19%, P = <0.001). South Asians were less likely than Whites to report depressive symptoms and to be offered specialist mental health services (Rate ratio = 0.75), and more likely to be referred back to the GP (Rate ratio = 1.83). South Asians were less likely to attend with a repeat episode (Rate ratio = 0.56). CONCLUSIONS: Young South Asian women are at high risk of self-harm, but their clinical risk appears to be lower in terms of the accepted contextual factors contributing to risk. Potentially useful service provision may include an interpersonal problem solving approach although to be effective, interventions would need to be acceptable to South Asian women and culturally appropriate.
72 citations
TL;DR: The predictive value of risk assessments after an episode of self harm was investigated and assessments made by emergency department staff with those made by psychiatric staff were compared.
Abstract: About one in six people repeat self harm within a year of an episode.1 Identifying people who are at risk of repetition is a key objective of assessment.2 We investigated the predictive value of risk assessments after an episode of self harm and compared assessments made by emergency department staff with those made by psychiatric staff.
Four hospitals provide emergency care in the cities of Manchester and Salford. As part of the Manchester and Salford self harm project (MASSH) we collected data on all people aged at least 16 who presented with self harm in 1997-2001.3 Doctors in the emergency department and, for those patients who received a psychiatric assessment, mental health staff completed comprehensive assessment forms (which included demographic items as well as details of the self harm episode, past history, and current mental state). The assessor was also asked for a global clinical assessment of the risk of repetition of self harm (low, moderate, or high). We used the MASSH database to determine whether …
70 citations
Cited by
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Camden and Islington NHS Foundation Trust1, University College London2, King's College London3, University of Melbourne4, University of Exeter5, Brighton and Sussex Medical School6, University of Manchester7, Tel Aviv University8, Johns Hopkins University9, University of Michigan10, Kaiser Permanente11, University of Washington12, University of Montpellier13, University of Edinburgh14, Dalhousie University15, University of Southern California16, University of Oslo17, Innlandet Hospital Trust18
TL;DR: The Lancet Commission on Dementia Prevention, Intervention, and Care met to consolidate the huge strides that have been made and the emerging knowledge as to what the authors should do to prevent and manage dementia.
3,826 citations
1,174 citations
New York University1, Bangor University2, Pompeu Fabra University3, University of Arkansas for Medical Sciences4, Hong Kong Polytechnic University5, University College London6, Alzheimer's Association7, Newcastle University8, Karolinska Institutet9, University of New South Wales10, Spanish National Research Council11, Cochrane Collaboration12, University of Washington13
TL;DR: NPTs emerge as a useful, versatile and potentially cost-effective approach to improve outcomes and QoL in ADRD for both the PWD and CG.
Abstract: Introduction: Nonpharmacological therapies (NPTs) can improve the quality of life (QoL) of people with Alzheimer’s disease (AD) and their carers. The objective of this study was to evaluate the best evidence on the effects of NPTs in AD and related disorders (ADRD) by performing a systematic review and meta-analysis of the entire field. Methods: Existing reviews and major electronic databases were searched for randomized controlled trials (RCTs). The deadline for study inclusion was September 15, 2008. Intervention categories and outcome domains were predefined by consensus. Two researchers working together detected 1,313 candidate studies of which 179 RCTs belonging to 26 intervention categories were selected. Cognitive deterioration had to be documented in all participants, and degenerative etiology
834 citations
TL;DR: The nature of the diagnostic process for IBS and how this impacts epidemiological measurements are discussed and there is no evidence that IBS is associated with an increased mortality risk.
Abstract: Irritable bowel syndrome (IBS) is a functional condition of the bowel that is diagnosed using clinical criteria. This paper discusses the nature of the diagnostic process for IBS and how this impacts epidemiological measurements. Depending on the diagnostic criteria employed, IBS affects around 11% of the population globally. Around 30% of people who experience the symptoms of IBS will consult physicians for their IBS symptoms. These people do not have significantly different abdominal symptoms to those who do not consult, but they do have greater levels of anxiety and lower quality of life. Internationally, there is a female predominance in the prevalence of IBS. There is 25% less IBS diagnosed in those over 50 years and there is no association with socioeconomic status. IBS aggregates within families and the genetic and sociological factors potentially underlying this are reviewed. Patients diagnosed with IBS are highly likely to have other functional disease and have more surgery than the general population. There is no evidence that IBS is associated with an increased mortality risk. The epidemiological evidence surrounding these aspects of the natural history is discussed.
691 citations