NCT03768674

Extreme Challenges - Psychopathology & Treatment Experiences Among Severly Selfharming Inpatients in Norway

Completed Last updated 21 June 2024

What this trial tests

trial testing Assessment of diagnoses, functioning and health services in Self Harm in 1,640 participants. Completed in 1 September 2021.

Timeline

1 October 2019

Primary endpoint
1 September 2021

1 September 2021

Quick facts

Lead sponsor	Oslo University Hospital
Status	Completed
Study type	OBSERVATIONAL
Enrollment	1,640
Start date	1 October 2019
Primary completion	1 September 2021
Estimated completion	1 September 2021
Sites	1 location across Norway

Drugs / interventions tested

• Assessment of diagnoses, functioning and health services

Conditions studied

• Self Harm — all drugs for Self Harm →
• Personality Disorders — all drugs for Personality Disorders →
• Psychosis — all drugs for Psychosis →
• Developmental Disorder — all drugs for Developmental Disorder →

Sponsor

Oslo University Hospital

Who can join

Adults 18 to 60, any sex, with Self Harm or Personality Disorders. Patients with the condition only — healthy volunteers not accepted.

Sponsor's own description

Patients who self-harm are a heterogeneous population. Outpatient treatments structured for borderline personality disorder are often recommended and hospitalization kept to a minimum. However, few studies have focused on the most severe, complex conditions with extreme suicide risk. A recent national investigation from Norway (2017) demonstrated a far larger cohort of extensively hospitalized inpatients with extreme self-harming behaviors than was expected (N=427) - identified in all health regions. Reported challenges were high-risk situations, severe medical sequelae, difficult collaborations across services, and uncertainty about psychiatric diagnoses.

Severe, often bizarre, self-harm is thus a major challenge for both patients and health services. In hospitals, safety measures can involve restrictions and involuntary regimes. As research on this target population is sparse, the current project seeks further understanding of complex conditions - psychopathology, treatment experiences and service collaboration.

The project is a national, multi-center cooperation including patients in psychiatric hospitals in all health regions. It is cross sectional. Data is based on diagnostic interviews, patients' self-reported symptoms and both patients and service providers treatment experiences. The inclusion period for inpatients (N=300) and a comparison sample of outpatients (N=300) is one year.

The target group is inpatients with extreme hospitalization and severe self-mutilation. A comparison group is patients with personality pathology attending outpatient treatments. Recruitment is across health regions.

Aim 1: Investigate psychopathology of patients in the target population and compare to a clinical sample admitted to outpatient treatment

Aim 2: Investigate personality functioning in the target population and compare to a clinical sample admitted to outpatient treatment

Aim 3: a) Investigate health service use in the target population and compare to a clinical sample admitted to outpatient treatment.

b) Investigate treatment experiences and health service collaborations in the target population.

The project will provide rational for future preventive treatment interventions

Publications & conference data

1 peer-reviewed publication reference this trial (live from Europe PMC):

1. 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.
   Langjord T, Pedersen G, Bovim T, Christensen TB, et al · · 2023 · cited 4× · PMID 37920539 · DOI 10.3389/fpsyt.2023.1258025