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      <ref-type name="Conference Proceedings">10</ref-type>
      <work-type>C-ACTI : Communications avec actes dans un congrès international</work-type>
      <contributors>
        <authors>
          <author>
            <style face="normal" font="default" size="100%">Gagnon-Dufresne, M.C.</style>
          </author>
          <author>
            <style face="normal" font="default" size="100%">Gautier, L.</style>
          </author>
          <author>
            <style face="normal" font="default" size="100%">Beaujoin, C.</style>
          </author>
          <author>
            <style face="normal" font="default" size="100%">Richard, Z.</style>
          </author>
          <author>
            <style face="normal" font="default" size="100%">Boivin, P.</style>
          </author>
          <author>
            <style face="normal" font="default" size="100%">Medeiros, S.</style>
          </author>
          <author>
            <style face="bold" font="default" size="100%">Ridde, Valéry</style>
          </author>
          <author>
            <style face="normal" font="default" size="100%">Zinszer, K.</style>
          </author>
        </authors>
      </contributors>
      <titles>
        <title>Have public health responses to COVID-19 considered social inequalities in health ? : insights from Brazil, Canada, France and Mali [résumé]</title>
        <secondary-title>Population Medicine</secondary-title>
        <secondary-title>World Congress on Public Health</secondary-title>
      </titles>
      <pages>A366 (1 )</pages>
      <keywords>
        <keyword>IRLANDE</keyword>
        <keyword>FRANCE</keyword>
        <keyword>BRESIL</keyword>
        <keyword>MALI</keyword>
        <keyword>CANADA</keyword>
      </keywords>
      <dates>
        <year>2023</year>
        <pub-dates>
          <date>2023/05/02-06</date>
        </pub-dates>
      </dates>
      <call-num>fdi:010095773</call-num>
      <language>ENG</language>
      <periodical>
        <full-title>Population Medicine</full-title>
      </periodical>
      <isbn>2654-1459</isbn>
      <electronic-resource-num>10.18332/popmed/165611</electronic-resource-num>
      <urls>
        <related-urls>
          <url>https://www.documentation.ird.fr/hor/fdi:010095773</url>
        </related-urls>
        <pdf-urls>
          <url>https://horizon.documentation.ird.fr/exl-doc/pleins_textes/2026-01/010095773.pdf</url>
        </pdf-urls>
      </urls>
      <volume>5 (Suppl.)</volume>
      <remote-database-provider>Horizon (IRD)</remote-database-provider>
      <abstract>Background: Research has indicated an increased risk of self-harm repetition and suicide among individuals with frequent self-harm episodes. Co-occurring physical and mental illness further increases the risk of self-harm and suicide. However, the association between this co-occurrence and frequent self-harm episodes is not well understood. We 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. Methods: The study included consecutive patients with five or more self-harm presentations to Emergency Departments across three general hospitals in the Republic of Ireland. The study included file reviews (n=183) and semi-structured interviews (n=36). Multivariate logistic regression models were used to test the association between the sociodemographic and the comorbidity variables on highly lethal self-harm acts. Thematic analysis was applied to identify themes related to the comorbidity and frequent self-harm repetition. Findings: Most of the participants were female (59.6%), single (56.1%) and unemployed (57.4%). The predominant current self-harm method was drug overdose (60%). Almost 90 % of the participants had history of a mental or behavioural disorder, and 56.8% had recent physical illness. The most common psychiatric diagnoses were alcohol use disorders (51.1%), borderline personality disorder (44.0%), and major depressive disorder (37.8%). Male gender (OR=2.89) and alcohol abuse (OR=2.64) were associated with highly lethal self-harm acts. Major 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. Participants 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. Conclusions: Physical and mental illness comorbidity was high among the participants. The mental and physical illness comorbidity of these patients should be addressed via a biopsychosocial assessment and subsequent interventions.</abstract>
      <custom6>050 ; 056 ; 106</custom6>
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