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Frequent attendance with self-harm: what might you be missing?
  1. Alex B Thomson1,
  2. Emma McAllister2,
  3. David Veale3,4
  1. 1 Department of Psychological Medicine, Northwick Park Hospital, Central and North West London NHS Foundation Trust, Harrow, Middlesex, UK
  2. 2 Lived Experience Advisor, UK
  3. 3 Centre for Anxiety Disorders and Trauma, South London and Maudsley NHS Foundation Trust, London, UK
  4. 4 Institute of Psychiatry Psychology and Neuroscience, King’s College London, London, UK
  1. Correspondence to Dr Alex B Thomson, Dept of Psychological Medicine, Northwick Park Hospital, Central and North West London NHS Foundation Trust, Harrow, Middlesex, UK; alex.thomson{at}nhs.net

https://doi.org/10.1136/emermed-2019-208974

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    Clinical introduction

    A 38-year-old professional is brought in by police extremely distressed and in pain. She reports intense feelings of contamination over her arms and torso and fears that this is spreading and killing other people or animals. She has tried neutralising this contamination by applying concentrated sodium hydroxide (figure 1). She was taken to various emergency departments (ED) 39 times in the last 8 months and has a history of serious overdoses requiring intensive care unit admission. She says she did …

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    Footnotes

    • Twitter @AlexBThomson

    • Contributors ABT: wrote the first draft of the manuscript and gained consent from the patient. EM: is the patient and co-wrote the manuscript. DV: edited and finalised the manuscript.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests None declared.

    • Patient consent for publication Obtained.

    • Provenance and peer review Not commissioned; internally peer reviewed.