Selvskading blant ungdom: Review og pilotstudie

The aim of this study was to review and summarize recent knowledge of deliberate self-harm among adolescents, which appear to be an increasing mental health problem. The study consisted of a review of essential literature and a pilot study where 3 pupils in senior high schools, who had experiences from deliberate self-harm, were interviewed. The review of 30 central and recent articles about deliberate self harm among adolescents in the period 1996-2005, identified risk factors for self-harm, protective factors, psychological mechanisms of self-harm, situation factors and triggers, functions, outcome, and maintaining factors of deliberate self-harm among adolescents. The qualitative pilot study, based on semi structured interviews, found that although several similarities among adolescents who self-harm can be identified, there are important individual differences. Main conclusions from the review and pilot study are: 1) The emotion regulation is a major function of self-harm. 2) Adolescents who self-harm have had experiences with psychological problems or problems with family, school, or behaviour. 3) Relations to peers are important since peers who had self-harmed was the strongest factor to influence self-harm, and since adolescents turn to their peers and friends for help and support when experiencing problems

Cognitive behavioral therapy for insomnia in euthymic bipolar disorder: study protocol for a randomized controlled trial

Background Patients with bipolar disorder experience sleep disturbance, even in euthymic phases. Changes in sleep pattern are frequent signs of a new episode of (hypo)mania or depression. Cognitive behavioral therapy for insomnia (CBT-I) is an effective treatment for primary insomnia, but there are no published results on the effects of CBT-I in patients with bipolar disorder. In this randomized controlled trial, we wish to compare CBT-I and treatment as usual with treatment as usual alone to determine its effect in improving quality of sleep, stabilizing minor mood variations and preventing new mood episodes in euthymic patients with bipolar disorder and comorbid insomnia. Methods Patients with euthymic bipolar I or II disorder and insomnia, as verified by the Structured Clinical Interview for DSM Disorders (SCID-1) assessment, will be included. The patients enter a three-week run-in phase in which they complete a sleep diary and a mood diary, are monitored for seven consecutive days with an actigraph and on two of these nights with polysomnography in addition before randomization to an eight-week treatment trial. Treatment as usual consists of pharmacological and supportive psychosocial treatment. In this trial, CBT-I will consist of sleep restriction, psychoeducation about sleep, stabilization of the circadian rhythm, and challenging and correcting sleep state misperception, in three to eight sessions. Discussion This trial could document a new treatment for insomnia in bipolar disorder with possible effects on sleep and on stability of mood. In addition, more precise information can be obtained about the character of sleep disturbance in bipolar disorder