Background
The project investigates patients with multiple or extensive hospital admissions due to severe self-harm. The aim is to explore a poorly studied self-harm cohort focusing on psychopathology, health service use and collaborations, and societal costs.
The study is a national research collaboration initiated by the Norwegian Personality Psychiatry Advisory Unit in collaboration with the Research Group Personality Psychiatry.
The project is approved by the Norwegian Ethics Committee. Twelve psychiatric hospitals from all health regions have contributed. A comparison group of outpatients is based on data from the Norwegian Network for Personality Disorders. Data collection started in 2019, after an interview-based pilot investigation. Data collection was completed by 2022.
Goals
The long-term goals are to increase knowledge and thus also possibility of more tailored intervention, on a small but highly clinically relevant patient cohort experiencing extensive self-harm-related health service utilization.
Financial support
The PhD project was mainly supported by the Damm Foundation. It has also received support from Oslo University Hospital.
Design
The current data collection has a cross-sectional design. It gives grounds for several articles (quantitative and qualitative designs) elaborating severe self-harm developments, different aspects of psychopathology and complex comorbidities, and experiences within and across health services. Publications are developed by collaborations involving the PhD candidate as well as additional, further research involving different members of the associated project group.
Project members
- Prosject leader/PhD supervisor: Elfrida Hartveit Kvarstein
- PhD candidate: Tuva Langjord (psykologisk institutt, PSI, UiO)
- PhD co-supervisors: Geir Pedersen (OUS) og Hanne Strømme (PSI, UiO)
Associated members
Specialist expertise
- NSSF: Fredrik Walby, University of Oslo (UiO)
- Child and Adolescent Mental Health Services (BUP): Ruth Kari Ramleth, Oslo University Hospital (OUS); Line Stänicke, University of Oslo (UiO)
- RVTS: Tone Bovim, Oslo University Hospital (OUS)
- TIPS: Kristin Li Romm, University of Oslo (UiO); Erlend Mork, Oslo University Hospital (OUS)
- Neuropsychiatry: Arvid Kildahl, Oslo University Hospital (OUS); Oddbjørn Hove, Helse Fonna Health Trust
- Psychosomatic medicine: Astrid Norheim, Diakonhjemmet Hospital
Lived-experience expertise
- Thea Røstbakken, Oslo University Hospital (OUS)
Personality Disorders Network
- Geir Pedersen, Oslo University Hospital (OUS)
NRAPP:
- Ingeborg U-M Eikenæs, Oslo University Hospital (OUS); Øyvind Urnes
Regional representatives from various health trusts
- Central Norway Regional Health Authority: Terje Torgersen, Sara Germans
- Western Norway Regional Health Authority: Tone Tveit
- South-Eastern Norway Regional Health Authority: Tore Buer Christensen, Johan Siqveland
- Northern Norway Regional Health Authority: Herman Tvete
- University Hospital of North Norway (UNN): Tordis Sørensen Høifødt, UiT – The Arctic University of Norway
Publications
- Kihldal AN et al (2025) Screening for autism in psychiatric inpatients with severe self-harm - results from the Extreme Challenges research project. Nord J Psychiatry. 2025 May;79(4):303-313. doi: 10.1080/08039488.2025.2497820. Epub 2025 May 4.PMID: 40319453
- Langjord, T. et al (2024) Evaluation of health services and treatment alliance among extensively hospitalized patients due to severe self-harm - results from the Extreme Challenges project. Nord J Psychiatry. 2024 Oct;78(7):591-602. doi: 10.1080/08039488.2024.2376162. Epub 2024 Aug 10. PMID: 39126325
- Langjord, T. et al (2023). Mental health disorders, functioning and health-related quality of life among extensively hospitalized patients due to severe selfharm – results from the Extreme Challenges project. Frontiers in Psychiatry, 14. https://doi.org/10.3389/fpsyt.2023.1258025
- Holth F et al (2018). Extreme challenges: psychiatric inpatients with severe self-harming behavior in Norway: a national screening investigation. Nordic Journal of Psychiatry. https://doi.org/10.1080/08039488.2018.1511751