Background
The project «Extreme challenges" includes two phases, first an initial interview-based screening investigation and secondly the main project, an extensive, cross national investigation focusing on psychopathology and health service experiences among patients with multiple and/or extensive hospital admissions due to severe self-harming behaviour.
The project is a national research collaboration initiated by NAPP (Norwegian Advisory Unit for Personality Psychiatry) in collaboration with the research group and the Norwegian Network for Personality Disorders. The project is approved by the Regional Committees for Medical and Health Research Ethics (REK). 12 psychiatric hospitals in all health regions are included. The comparison group is patients from the Network for Personality Disorders.
Design
The project has a cross-sectional design, where the information is collected once per patient. Data collection began in 2019 following a preliminary pilot investigation and was completed in 2021. Several articles are under production. The focus of these is on 1) Psychopathology in the self-harming sample, 2) Health service use, 3) Health service collaboration, and 4) A qualitative article focusing on the participants' own understanding of self-harm.
Organization
- The project centre is at the Section for Personality Psychiatry and Specialized Policlinics, Oslo University Hospital.
- Principle Investigator and main PhD supervisor: Elfrida Hartveit Kvarstein, head senior consultant and associate professor (OUS/UiO).
- Cosupervisors: Geir Pedersen and Hanne Strømme.
- PhD candidate: Psychologist Tuva Langjord (University of Oslo).
- The project is run in collaboration with a national project group consisting of researchers and clinicians working in adjacent fields, and experience consultants.
- Oslo University Hospital and The Damm Foundation funds the PhD project (2019–2023).
Collaborators
The project is run in collaboration with a national project group consisting of researchers and clinicians working in adjacent fields, and experience consultants. The national project group is central in all phases; design, preparations, implementation procedures, evaluation, and presentations of results. It covers all health regions (HR) and has included the following participants:
- Middle HR: T. Torgersen, S. Germans
- Western HR: T. Tveit
- Southeastern HR: P.A. Ringen, P. Danielsen, J. Siqveland
- Northern HR: H.Tvete, T. Sørensen Høifødt
- National Centre, Suicide Research and Prevention: F. Walby, R. K. Ramleth
- Adolescent Psychiatry: L. Stänicke, R. K. Ramleth
- Regional Centre, Violence and Traumatic Stress: T. Bovim, A. Nuilla, I. Lunde
- Early intervention Psychosis: K. L. Romm, E. Mork
- Personality Psychiatry National Advisory Unit: Ø.Urnes, I. U-M. Eikenæs, K. Bremer
- Neurodevelopmental disorders/intellectual disability A. Kildal, O. Hove
- User experience: T. Røstbakken, M. Pettersen, A. Holst.
- Psychosomatic/Liasson Psychiatry: T. Small, A. B. Norheim
- Screening interviews F. Holth
Publications
- Langjord, T., Pedersen, G., Bovim, T., Christensen, T. B., Eikenæs, I. U.-M., Hove, O., Kildahl, A. N., Mork, E., Norheim, A. B., Ramleth, R. K., Ringen, P. A., Romm, K. L., Siqveland, J., Schønning, T., Stänicke, L. I., Torgersen, T., Pettersen, M. S., Tveit, T., Urnes, Ø., Walby, F. A., & Kvarstein, E. H. (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, Walby F, Røstbakken T, Lunde I, Ringen PA, Ramleth RK, Romm KL, Tveit T, Torgersen T, Urnes Ø & Kvarstein EH (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