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<Provider Id="sundheddkcms"> <Item Id="{25BF63AA-D075-4752-9B28-F8BB66ABE3C5}" Name="selvskade" Type="LHContentPage" ParentProviderId="sundheddkcms" ParentItemId="{0627C0F4-93F0-4C6D-8725-556C662880DE}" SortOrder="1350" PublishDate="2018-11-16T12:36:00" DeleteDate="2999-12-31T00:00:00" PotItemType=""> <Content> <HtmlField Name="PageContent"><![CDATA[<h2>Diagnose</h2> <h3>Diagnostisk tankegang og kliniske fund</h3> <ul> <li>Vær opmærksom på tegn på selvskade, fx ved skadestuebesøg, eller ved somatisk undersøgelse af anden årsag: <ul> <li>I form af ofte parallelle snitsår og ar af vekslende alder, typisk på underarmene og indersiden af lårene evt. på abdomen</li> <li>Cirkulære brandsår efter cigaretter ses typisk på underarmene</li> <li>Ophobning af knoglebrud fx af fingrenes knogler</li> </ul> </li> <li>Der er udtalt komorbiditet med <a href="~/link.aspx?_id=35E56697840544379F3EAF2498924B57&_z=z">personlighedsforstyrrelser</a> (særligt emotionelt ustabil personlighedsforstyrrelse af borderline type, hvor selvskaden kan udløses af følelsen af tomhed og forladthed og svigt), som findes hos ca. 50 %</li> <li>Spiseforstyrrelser er også tilsvarende hyppige, ligesom 45 % opfylder en<a href="~/link.aspx?_id=D4645C30301C44A9A52178A907940C23&_z=z"> depressionsdiagnose</a></li> <li>Spørg ud om trang til selvskade hos unge, også ved ringe mistanke, hvis disse virker til at mistrives ("Kan du blive så meget ude af dig selv, at du skader dig selv ved at skære eller brænde dig?”)</li> </ul> <h3>Sygehistorie</h3> <ul> <li>Man skal forsøge at afdække evt. bagvedliggende depression eller psykose</li> <li>Interview om patientens sociale situation</li> <li>Det er også vigtigt at danne sig et skøn over patientens begavelsesniveau, evt. ved neuropsykologisk testning ved mistanke om et af ovennævnte syndromer</li> </ul> <h3>Supplerende undersøgelser i almen praksis</h3> <ul> <li>Nøjere beskrivelse af omfanget af selvskade</li> <li>Psykiatrisk anamnese</li> <li>Personer i patientens netværk, som kan støtte ham eller hende</li> <li>Mulighed for samarbejde med sundhedsplejerske eller andre</li> </ul> <h3>Andre undersøgelser hos specialist</h3> <ul> <li>Psykiatrisk udredning og diagnostik</li> <li>Evt. neuropsykologisk undersøgelse</li> </ul> <h3>Differentialdiagnose</h3> <ul> <li>Differentialdiagnostikken overfor hesitationssnit (øvelse i at tolerere smerten inden det egentlige selvmord) ved depression er overordentligt vigtig</li> <li>Selvskade i forbindelse med psykoser kræver oftest akut indlæggelse</li> </ul> <h2>Behandling</h2> <ul> <li>Efter udelukkelse af sværere psykopatologi, som først skal behandles, kan selvskade behandles ved Mentaliseringsbaseret terapi (MBT) og Dialektisk adfærdsterapi (DAT), hvor der er gode resultater <ul> <li>Ved MBT lægges vægt på, at patienten i højere grad skal kunne genkende og sætte navn på egne følelser og oplevelser, for at om muligt at forlænge perioden fra impuls til handling ved at være reflekterende til stede i nuet</li> <li>DAT er en videreudvikling af kognitiv adfærdsterapi, hvor der bl.a. lægges vægt på mestring af variationer af stemningslejet og af stress. Behandlingen foregår dels i gruppe dels individuelt og lægger meget vægt på hjemmearbejde </li> </ul> </li> <li>Ved det meget impulsive type kan <a href="http://pro.medicin.dk/Laegemiddelgrupper/Grupper/243058">SSRI</a> behandling som supplement have en gavnlig virkning</li> </ul> <h3>Behandlingsmål</h3> <ul> <li>At lære patienten at mestre ubehagelige følelser uden at gribe til selvskade</li> <li>At give patienten muligheden for selv at kunne skabe forståelse og indsigt i sit følelsesliv</li> <li>At fremme patientens følelsesmæssige og sociale formåen</li> </ul> <ul> </ul> <h3>Håndtering i almen praksis</h3> <ul> <li>Ved mistanke, henvis til psykolog eller psykiater, Se ovenfor</li> </ul> <h3>Råd til patienten</h3> <ul> <li>Opsøg hjælp. Enten hos pårørende eller professionelle </li> <li>I visse former for terapi er der indbygget en høj grad af hjemmearbejde. I forbindelse med dette fører patienten dagbog over sit liv og sine følelser i forbindelse med vigtige interpersonelle begivenheder, for at forstå, hvorfor han handler, som han gør</li> </ul> <h3>Medicinsk behandling</h3> <ul> <li>Ved det meget impulsive type kan <a href="http://pro.medicin.dk/Laegemiddelgrupper/Grupper/243058">SSRI</a> behandling som supplement have en gavnlig virkning</li> </ul> <h3>Anden behandling</h3> <ul> <li> Mentaliseringsbaseret terapi (MBT) og Dialektisk adfærdsterapi (DAT), se ovenfor</li> </ul> <h3>Forebyggende behandling</h3> <ul> <li>Øget opmærksomhed overfor unge, der enten udviser tegn på mistrivsel eller hvor man er vidende om, at de er i risiko, fx pga. vanrøgt, incest, alvorlig sygdom eller død af forælder osv.</li> </ul> <h2>Henvisning</h2> <ul> <li>Patienter med mere end bare enkeltstående selvskade bør i tvivlstilfælde henvises til psykiater mhp. vurdering</li> <li>Sværere tilfælde henvises altid</li> <li>Patienten kan behandles af psykolog eller psykiater med kendskab til MBT eller DAT (se nedenfor)</li> <li>Mere komplicerede tilfælde kan henvises til regionale tilbud om DAT</li> </ul> <h2>Opfølgning</h2> <ul> <li>Det vil være naturligt og vigtigt for pt. at lægen ved senere lejligheder at spørge til, hvordan det går</li> </ul> <h2>Sygdomsforløb, komplikationer og prognose</h2> <h3>Sygdomsforløb</h3> <ul> <li>Risikoen for selvmordsforsøg og selvmord er stærkt forøget</li> <li>Prognosen afhænger bl.a. af, om patienten hurtigt kommer i behandling</li> </ul> <h3>Komplikationer</h3> <ul> <li>Alvorlige somatiske skader</li> <li>Afhængighed af cutting sv.t. andre former for afhængighed</li> <li>Selvskade medfører skamfølelse, mindsket selvrespekt og ofte øget isolation og ensomhed, som igen kan gøre det vanskeligere at undgå selvskade</li> </ul> <h3>Prognose</h3> <ul> <li>Afhængig af baggrunden for selvskaden. Men forøget risiko for senere selvmord</li> </ul> <h2>Baggrundsoplysninger<a href=" " data-type="journal-reference" data-value="Reuter Morthorst B, Soegaard B, Nordentoft M, Erlangsen A, Incidence Rates of Deliberate Self-Harm in Denmark 1994-2011. Crisis 2016;37: 256-264" data-value-piped="Reuter Morthorst B, Soegaard B, Nordentoft M, Erlangsen A|Incidence Rates of Deliberate Self-Harm in Denmark 1994-2011.|Crisis|2016|37|256-264|27278571" data-url="reference-link" data-pubmedid="27278571" title="Reuter Morthorst B, Soegaard B, Nordentoft M, Erlangsen A, Incidence Rates of Deliberate Self-Harm in Denmark 1994-2011. Crisis 2016;37: 256-264"><sup>1</sup></a><sup>,</sup><a href=" " data-type="journal-reference" data-value="Møhl B, Rubæk L, [Self-injury, converting emotional distress into physical pain].. Ugeskr Laeger 2017;179: " data-value-piped="Møhl B, Rubæk L|[Self-injury, converting emotional distress into physical pain].|Ugeskr Laeger|2017|179||28648163" data-url="reference-link" data-pubmedid="28648163" title="Møhl B, Rubæk L, [Self-injury, converting emotional distress into physical pain].. Ugeskr Laeger 2017;179: "><sup>2</sup></a></h2> <h3>Definition</h3> <ul> <li>Selvskadende adfærd er ikke en selvstændig diagnose i ICD-10 eller DSM 5 systemet, men ses ved en række forskellige psykiske sygdomme. Det kan fx være personlighedsforstyrrelser, depression og psykoser, som <a href="~/link.aspx?_id=CB8C01F803A842338D70BDDD29AE12C3&_z=z">skizofreni</a></li> <li>Adfærden betegnes også for selvmutilerende adfærd og defineres som en bevidst, direkte og selvpåført ødelæggelse af kropsvæv medførende umiddelbar vævsskade af grunde, der ikke er socialt sanktionerede og uden suicidalt øjemed</li> <li>Formålet er hyppigt bevidst eller ubevidst at opnå følelsesmæssig lettelse eller for at påvirke forholdet til andre</li> <li>Når det anføres, at handlingen ikke er socialt sanktioneret, er det for at udelukke alle de kulturelt accepterede former for selvskade (fx piercinger, visse religiøse og kulturelle ritualer osv.), men det udelukker ikke selvskadende handlinger, der er acceptable i fx en ungdomssubkultur, hvor medlemmer støtter hinanden i fx at skære sig selv</li> </ul> <h3>Forekomst</h3> <ul> <li>Selvskade kan være et fænomen, som kan have store somatiske og psykiske følgevirkninger</li> <li>Det kan desuden være et udtryk for alvorlig psykopatologi og kan prædikere <a href="~/link.aspx?_id=1A1FCEE64AC040A9AF4DF05E46C7A34A&_z=z">selvmordsforsøg og selvmord</a>, idet risikoen for selvmord er forøget med en faktor 12 hos personer der selvskader</li> <li>Prævalensen af selvskade i løbet af livet er omkring 20 % hos danske gymnasieelever, og 16 % havde udført selvskade mindst én gang indenfor det sidste år<a href=" " data-type="journal-reference" data-value="Møhl B, Skandsen A, The prevalence and distribution of self‐harm among Danish high school students. Personality and Mental Health 2012;6: 147-55" data-value-piped="Møhl B, Skandsen A|The prevalence and distribution of self‐harm among Danish high school students|Personality and Mental Health|2012|6|147-55|" data-url="reference-link" title="Møhl B, Skandsen A, The prevalence and distribution of self‐harm among Danish high school students. Personality and Mental Health 2012;6: 147-55"><sup>3</sup></a> </li> <li>De hyppigste metoder er at slå, skære eller brænde sig selv. De fleste bruger flere metoder på skift</li> <li>Der kan skelnes mellem tre typer selvskade: <ol> <li>Den impulsive</li> <li>Den stereotype og tvangsmæssige </li> <li>Den alvorlige/svære selvskade</li> </ol> </li> </ul> <ol> <li><strong>Impulsiv selvskade</strong> <ul> <li>Den almindeligste form og omfatter fx cutting, brænding og at slå sig selv</li> <li>Formålet med impulsiv selvskade er at opnå en hurtig (omend kortvarig) lettelse af indre spænding og kan således bruges som metode til affektregulering, dvs. nedregulering af pinagtige følelser</li> <li>Denne form for selvskade udløses af meget forskellige følelser, som fx selvhad, had mod andre, angst for at blive forladt, følelsen af indre tomhed, håbløshed og et ønske om at opnå kontrol</li> <li>Ofte vil den selvskadende person have svært ved præcist at angive, hvilke følelser der udløser selvskaden, men disse kan ofte identificeres og dermed modificeres gennem psykoterapi</li> </ul> </li> <li><strong>Den stereotype eller tvangsmæssige form</strong> for selvskade <ul> <li>Karakteriseret ved, at personen gentager sin adfærd igen og igen på en måde, som er monoton eller rytmisk.</li> <li>Patienter med mental retardering, autisme eller særlige syndromer som <a href="~/link.aspx?_id=22747F2FD39544D797E1CD7EEF5FC66A&_z=z">Prader-Willi</a>, <a href="~/link.aspx?_id=295A4696F13F42118B4B2CB2EA2F2C23&_z=z">Cornelia de Lange</a> og <a href="~/link.aspx?_id=28E5330753014F0CA7F479823909ACD6&_z=z">Lesch-Nyhans syndrom</a>, kan have en tvangsmæssig selvskadende adfærd</li> <li>Meget mere almindeligt og overlappende er de ikke nødvendigvis sikkert patologiske former, som neglebidning, skin-picking, hvor personen finder uregelmæssigheder i sin hud, som hun så forsøger at fjerne fx hudorme, eller <a href="~/link.aspx?_id=4034E646A4B4476B8E18355817268EDC&_z=z">trikotillomani</a>, hvor personen trækker hår ud fra hovedbunden, øjenvipper og -bryn eller fra pubesbehåringen</li> </ul> </li> <li><strong>Svær eller alvorlig selvskade</strong> er omfattende, definitive og dramatiske som fx øjenamputationer, penisamputation og lignende, og er oftest er forbundet med psykotiske tilstande. Sådan selvskade har således ikke noget med impulsforstyrrelser at gøre</li> </ol> <h3>Ætiologi og patogenese</h3> <ul> <li>Selvskade har baggrund i mange forskellige forstyrrelser, men ses også som et relativt uspecifikt symptom, typisk hos personer med et svært belastet opvækstmiljø, måske involverende seksuelle overgreb</li> <li>Endelig er der de seneste år tilkommet en ny stor gruppe af selvskadende unge med relativt mindre belastet baggrund og mindre psykopatologi, end vi tidligere har set. Disse unge er socialt tilpassede og ”lærer” cuttingadfærden af hinanden evt. via sociale medier. Adfærden benyttes som en form for affektregulering for at komme af med skamfølelse, og kompensere for lav selvfølelse</li> <li>En dansk undersøgelse viste således, at 76 % skadede sig selv for at komme af med negative følelser, 45 % ønskede at straffe sig selv, 45 % ønskede opmærksomhed, 34 % at finde ud af, om der var nogen, der virkelig følte omsorg for dem, mens 30 % angav selvskade begrundet i at skræmme andre</li> <li>Mange patienter, der selvskader, angiver at en række negative følelser blev reduceret signifikant, mens nogle positive følelser blev øget med den selvskadende handling (se figur)<br> <br> <img alt="" height="461" width="657" src="6C5F8EEF736F4C6EA695B8F75C09A735-0-0"></li> <li>Ved depressive tilstande kan gentagen selvskade ses som en form for øvelse i at tolerere smerten (såkaldte hesitationssnit) inden det egentlige selvmord. Dette er selvfølgelig meget vigtigt at erkende</li> <li>Selvskade kan også forekomme som en form for selvafstraffelse fx ved psykotiske depressioner</li> <li>Alvorligere selvskade som amputation af øjet eller kønsorganerne forekommer ved skizofreni </li> </ul> <h3>Disponerende faktorer</h3> <ul> <li>En stor del af de unge, der har selvskade, er ”smittet” af andre unge og via sociale medier, hvor de lærer at fx cutting er en hensigtsmæssig måde at håndtere svære følelser, som skam og mindreværd</li> <li>Mistrivsel af enhver art kan øge risikoen for selvskade</li> <li>Personlighedsforstyrrelser vil meget tit være associeret til selvskade</li> <li>Depressioner</li> <li>Psykoser</li> </ul> <h3>ICPC-2</h3> <p>[ICPC]</p> <h3>ICD-10/SKS-koder</h3> <p><span>X71-X83 angiver forskellige former for selvpåført skade incl. ved selvmordsforsøg</span></p> <p>[ICD10]</p> <h3>Hvad findes af skriftlig information</h3> <ul> <li><a rel="noopener noreferrer" href="https://www.lmsos.dk/laegeportal" target="_blank">Landsforeningen mod Spiseforstyrrelser og Selvskade (LMS) Lægeportal </a></li> <li>Møhl, B. Selvskade – psykologi og behandling. Hans Reitzels forlag, 2015</li> <li>Møhl, B. At skære smerten bort – en bog om cutting og anden selvskadende adfærd. Psykiatrifondens forlag. 2006</li> </ul> <h2>Link til vejledninger</h2> <ul> <li>Forløbsbeskrivelser og pakkeforløb [ICPC] </li> </ul>]]></HtmlField> <HtmlField Name="Resume"><![CDATA[<h2>Resumé</h2> <h3>Diagnose</h3> <ul> <li>Mange forskellige tilstande og psykiatriske sygdomme kan ligge bag selvskade</li> <li>Det er vigtigt at udrede dette, specielt at identificere tilfælde af depression og psykose</li> <li>Risikoen for selvmord på sigt er forøget</li> </ul> <h3>Behandling</h3> <ul> <li>Psykoterapi. Mentaliseringsbaseret terapi (MBT) og Dialektisk adfærdsterapi (DAT)</li> </ul> <h3>Henvisning</h3> <ul> <li>Ved mistanke om psykose eller depression</li> <li>Patienter med mere end bare enkeltstående selvskade bør i tvivlstilfælde henvises til psykolog eller psykiater mhp. vurdering</li> </ul>]]></HtmlField> <LinkListField Name="Spot2"> <LinkField linktype="internal">{99A85AFD-2F7A-4B5D-A1C9-C2701D5E7D30}</LinkField> </LinkListField> <TextField Name="DoctorsHandbookID">40248</TextField> <TextField Name="PageTitle">Selvskade</TextField> <TextField Name="NavigationTitle">Selvskade</TextField> <CheckBoxField Name="ShowInMenu">true</CheckBoxField> <CheckBoxField Name="ShowInContentField">true</CheckBoxField> <DateTimeField Name="RevisedDate">2024-04-17T12:08:00</DateTimeField> <LinkListField Name="Authors"> <LinkField linktype="internal">{5531EBCE-6AFF-4BA4-87EC-A9AC835E7AFD}</LinkField> <LinkField linktype="internal">{9240F87A-FE81-40E5-A079-F715F683A0B5}</LinkField> </LinkListField> 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