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    Self-harm and suicidal acts: a suitable case for treatment of impulsivity-driven behaviour with repetitive transcranial magnetic stimulation (rTMS). 
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    • Self-harm and suicidal acts: a suitable case for treatment of impulsivity-driven behaviour with repetitive transcranial magnetic stimulation (rTMS).
    •   QMRO Home
    • Wolfson Institute of Preventive Medicine
    • Centre for Psychiatry
    • Self-harm and suicidal acts: a suitable case for treatment of impulsivity-driven behaviour with repetitive transcranial magnetic stimulation (rTMS).
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    Self-harm and suicidal acts: a suitable case for treatment of impulsivity-driven behaviour with repetitive transcranial magnetic stimulation (rTMS).

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    Published version (205.2Kb)
    Volume
    1
    Pagination
    87 - 91
    DOI
    10.1192/bjpo.bp.115.000315
    Journal
    BJPsych Open
    Issue
    1
    ISSN
    2056-4724
    Metadata
    Show full item record
    Abstract
    SUMMARY: Suicidal thinking, self-harm and suicidal acts are common, although determining their precise prevalence is complex. Epidemiological work has identified a number of associated demographic and clinical factors, though, with the exception of past acts of self-harm, these are non-specific and weak future predictors. There is a critical need shift focus from managing 'suicidality-by-proxy' through general mental health treatments, to better understand the neuropsychology and neurophysiology of such behaviour to guide targeted interventions. The model of the cognitive control of emotion (MCCE) offers such a paradigm, with an underlying pan-diagnostic pathophysiology of a hypoactive prefrontal cortex failing to suitably inhibit an overactive threat-responding limbic system. The result is a phenotype - from any number of causative gene-environment interactions - primed to impulsively self-harm. We argue that such neural dysconnectivity is open to potential therapeutic modification from repetitive transcranial magnetic stimulation (rTMS). The current evidence base for this is undoubtedly extremely limited, but the societal and clinical burden self-harm and suicide pose warrants such investigation. DECLARATION OF INTEREST: K.B. is the Editor of BJPsych Open, but had no editorial involvement in the review or decision process regarding this paper. COPYRIGHT AND USAGE: © The Royal College of Psychiatrists 2015. This is an open access article distributed under the terms of the Creative Commons Non-Commercial, No Derivatives (CC BY-NC-ND) licence.
    Authors
    Tracy, DK; Shergill, SS; David, AS; Fonagy, P; Zaman, R; Downar, J; Eliott, E; Bhui, K
    URI
    http://qmro.qmul.ac.uk/xmlui/handle/123456789/18226
    Collections
    • Centre for Psychiatry [748]
    Language
    eng
    Licence information
    Distributed under the terms of the Creative Commons Non-Commercial, No Derivatives (CC BY-NC-ND) licence.
    Copyright statements
    © The Royal College of Psychiatrists 2015.
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