@inproceedings{fdi:010095773,
  title = {{H}ave public health responses to {COVID}-19 considered social inequalities in health ? : insights from {B}razil, {C}anada, {F}rance and {M}ali [r{\'e}sum{\'e}]},
  author = {{G}agnon-{D}ufresne, {M}.{C}. and {G}autier, {L}. and {B}eaujoin, {C}. and {R}ichard, {Z}. and {B}oivin, {P}. and {M}edeiros, {S}. and {R}idde, {V}al{\'e}ry and {Z}inszer, {K}.},
  editor = {},
  language = {{ENG}},
  abstract = {{B}ackground: {R}esearch has indicated an increased risk of self-harm repetition and suicide among individuals with frequent self-harm episodes. {C}o-occurring physical and mental illness further increases the risk of self-harm and suicide. {H}owever, the association between this co-occurrence and frequent self-harm episodes is not well understood. {W}e examined the profile of individuals with frequent self-harm episodes and the association between physical and mental illness comorbidity, self-harm repetition and highly lethal self-harm acts. {M}ethods: {T}he study included consecutive patients with five or more self-harm presentations to {E}mergency {D}epartments across three general hospitals in the {R}epublic of {I}reland. {T}he study included file reviews (n=183) and semi-structured interviews (n=36). {M}ultivariate logistic regression models were used to test the association between the sociodemographic and the comorbidity variables on highly lethal self-harm acts. {T}hematic analysis was applied to identify themes related to the comorbidity and frequent self-harm repetition. {F}indings: {M}ost of the participants were female (59.6%), single (56.1%) and unemployed (57.4%). {T}he predominant current self-harm method was drug overdose (60%). {A}lmost 90 % of the participants had history of a mental or behavioural disorder, and 56.8% had recent physical illness. {T}he most common psychiatric diagnoses were alcohol use disorders (51.1%), borderline personality disorder (44.0%), and major depressive disorder (37.8%). {M}ale gender ({OR}=2.89) and alcohol abuse ({OR}=2.64) were associated with highly lethal self-harm acts. {M}ajor qualitative themes were a) the functional meaning of self-harm b) self-harm comorbidity c) family psychiatric history and d) contacts with mental health services. {P}articipants described experiencing an uncontrollable self-harm urge, and self-harm was referred to as a way to get relief from emotional pain or self- punishment to cope with anger and stressors. {C}onclusions: {P}hysical and mental illness comorbidity was high among the participants. {T}he mental and physical illness comorbidity of these patients should be addressed via a biopsychosocial assessment and subsequent interventions.},
  keywords = {{IRLANDE} ; {FRANCE} ; {BRESIL} ; {MALI} ; {CANADA}},
  volume = {5 ({S}uppl.)},
  numero = {},
  pages = {{A}366 (1 )},
  booktitle = {},
  year = {2023},
  DOI = {10.18332/popmed/165611},
  ISSN = {2654-1459},
  URL = {https://www.documentation.ird.fr/hor/fdi:010095773},
}