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Zhong R, Wang Z, Zhu Y, Wu X, Wang X, Wu H, Zhou J, Li X, Xu G, Pan M, Chen Z, Li W, Jiao Z, Li M, Zhang Y, Chen J, Chen X, Li N, Sun J, Zhang J, Hu S, Gan Z, Qin Y, Wang Y, Ma Y, Fang Y. Prevalence and correlates of non-suicidal self-injury among patients with bipolar disorder: A multicenter study across China. J Affect Disord 2024; 367:333-341. [PMID: 39233245 DOI: 10.1016/j.jad.2024.08.231] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/01/2024] [Revised: 08/24/2024] [Accepted: 08/31/2024] [Indexed: 09/06/2024]
Abstract
BACKGROUND Non-suicidal self-injury (NSSI) is increasingly prevalent among patients with bipolar disorder (BD), raising concerns in psychology and mental health. Investigating the incidence and factors associated with NSSI is crucial for developing prevention and intervention strategies. METHODS NSSI behaviors were identified using the Ottawa Self-injury Inventory. The Clinically Useful Depression Outcome Scale supplemented with questions for the DSM-5 specifier of mixed features (CUDOS-M) and the Mini International Neuropsychiatric Interview (Hypo-)Manic Episode with Mixed Features-DSM-5 Module (MINI-M) were used to evaluate clinical symptoms. Non-parametric tests, chi-square tests, point-biserial correlation and logistic regression analyses were employed for the purposes of data analysis. RESULTS The enrolled sample comprised 1044 patients with BD from 20 research centers across China. Out of 1044 individuals, 446 exhibited NSSI behaviors, with 101 of them being adolescents, leading to a prevalence of 78.3 % among adolescent patients. The most common methods for females and males were "cutting" (41.2 %) and "hitting" (34.7 %), respectively. By binary logistic regression analysis, young age, female, bipolar type II disorder, with suicidal ideation and mixed states, depressive symptoms and without family history of mental disorder were correlates of NSSI in patients with BD (P < 0.05). LIMITATIONS As a cross-sectional study, causality between NSSI behaviors and associated factors cannot be established. Reporting and recall biases may occur due to self-rating scales and retrospective reports. CONCLUSION Our study indicates a concerning prevalence of NSSI, particularly among young patients with BD in China. Future research should focus on understanding NSSI behaviors in this population and developing effective interventions.
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Affiliation(s)
- Rongrong Zhong
- Clinical Research Center & Division of Mood Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, 200030, China
| | - Zuowei Wang
- Shanghai Hongkou Mental Health Center, 200083, China; Clinical Research Center for Mental Health, School of Medicine, Shanghai University, 200083, China
| | - Yuncheng Zhu
- Shanghai Hongkou Mental Health Center, 200083, China; Clinical Research Center for Mental Health, School of Medicine, Shanghai University, 200083, China.
| | - XiaoHui Wu
- Clinical Research Center & Division of Mood Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, 200030, China
| | - Xiaoping Wang
- The Second Xiangya Hospital of Central South University, 410012, China
| | - Haishan Wu
- The Second Xiangya Hospital of Central South University, 410012, China
| | - Jia Zhou
- Beijing Anding Hospital, Capital Medical University, 100088, China
| | - Xiaohong Li
- Beijing Anding Hospital, Capital Medical University, 100088, China
| | - Guiyun Xu
- The Affiliated Brain Hospital of Guangzhou Medical University, 510370, China
| | - Miao Pan
- The Second Affiliated Hospital of Xinxiang Medical University, 453002, China
| | - Zhiyu Chen
- Hangzhou Seventh People's Hospital, 310063, China
| | - Wenfei Li
- Anhui Mental Health Center, 230022, China
| | - Zhian Jiao
- Shandong Provincial Hospital, 250021, China
| | - Mingli Li
- West China Hospital Sichuan University, 610044, China
| | | | | | - Xiuzhe Chen
- Shandong Mental Health Center, 250014, China
| | - Na Li
- The first Affiliated Hospital of Kunming Medical College, 650032, China
| | - Jing Sun
- Nanjing Brain Hospital, 210024, China
| | - Jian Zhang
- Shenzhen Kang Ning Hospital, 518020, China
| | - Shaohua Hu
- The First Affiliated Hospital Zhejiang University School of Medicine, 310003, China
| | - Zhaoyu Gan
- No. 3 Hospital of Zhongshan University, 510630, China
| | - Yan Qin
- Dalian Seventh People's Hospital, 116086, China
| | - Yumei Wang
- The First Hospital of Hebei Medical University, 50030, China
| | - Yantao Ma
- Peking University Institute of Mental Health, 100191, China
| | - Yiru Fang
- Clinical Research Center & Division of Mood Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, 200030, China; Department of Psychiatry & Affective Disorders Center, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, 200025, China; Clinical Research Center for Mental Health, School of Medicine, Shanghai University, 200083, China.
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Sun T, Liu J, Wang H, Yang BX, Liu Z, Liu J, Wan Z, Li Y, Xie X, Li X, Gong X, Cai Z. Risk Prediction Model for Non-Suicidal Self-Injury in Chinese Adolescents with Major Depressive Disorder Based on Machine Learning. Neuropsychiatr Dis Treat 2024; 20:1539-1551. [PMID: 39139655 PMCID: PMC11319100 DOI: 10.2147/ndt.s460021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/09/2024] [Accepted: 07/23/2024] [Indexed: 08/15/2024] Open
Abstract
Background Non-suicidal self-injury (NSSI) is a significant social issue, especially among adolescents with major depressive disorder (MDD). This study aimed to construct a risk prediction model using machine learning (ML) algorithms, such as XGBoost and random forest, to identify interventions for healthcare professionals working with adolescents with MDD. Methods This study investigated 488 adolescents with MDD. Adolescents was randomly divided into 75% training set and 25% test set to testify the predictive value of risk prediction model. The prediction model was constructed using XGBoost and random forest algorithms. We evaluated the area under the receiver operating characteristic curve (AUC), sensitivity, specificity, accuracy, recall, F Score of the two models for comparing the performance of the two models. Results There were 161 (33.00%) participants having NSSI. Compared without NSSI, there were statistically significant differences in gender (P=0.035), age (P=0.036), depressive symptoms (P=0.042), sleep quality (P=0.030), dysfunctional attitudes (P=0.048), childhood trauma (P=0.046), interpersonal problems (P=0.047), psychoticism (P) (P=0.049), neuroticism (N) (P=0.044), punishing and Severe (F2) (P=0.045) and Overly-intervening and Protecting (M2) (P=0.047) with NSSI. The AUC values for random forest and XGBoost were 0.780 and 0.807, respectively. The top five most important risk predictors identified by both machine learning methods were dysfunctional attitude, childhood trauma, depressive symptoms, F2 and M2. Conclusion The study demonstrates the suitability of prediction models for predicting NSSI behavior in Chinese adolescents with MDD based on ML. This model improves the assessment of NSSI in adolescents with MDD by health care professionals working. This provides a foundation for focused prevention and interventions by health care professionals working with these adolescents.
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Affiliation(s)
- Ting Sun
- Department of Nursing, Renmin Hospital of Wuhan University, Wuhan, People’s Republic of China
- Health Science Center, Yangtze University, Jingzhou, People’s Republic of China
| | - Jingfang Liu
- Department of Psychiatry, Renmin Hospital of Wuhan University, Wuhan, People’s Republic of China
| | - Hui Wang
- Department of Psychiatry, Renmin Hospital of Wuhan University, Wuhan, People’s Republic of China
| | - Bing Xiang Yang
- Department of Psychiatry, Renmin Hospital of Wuhan University, Wuhan, People’s Republic of China
- School of Nursing, Wuhan University, Wuhan, People’s Republic of China
- Population and Health Research Center, Wuhan University, Wuhan, People’s Republic of China
| | - Zhongchun Liu
- Department of Psychiatry, Renmin Hospital of Wuhan University, Wuhan, People’s Republic of China
| | - Jie Liu
- Anesthesiology, Virginia Commonwealth University Health System, Richmond, VA, USA
| | - Zhiying Wan
- Department of Psychiatry, Renmin Hospital of Wuhan University, Wuhan, People’s Republic of China
| | - Yinglin Li
- Department of Nursing, Renmin Hospital of Wuhan University, Wuhan, People’s Republic of China
| | - Xiangying Xie
- Department of Nursing, Renmin Hospital of Wuhan University, Wuhan, People’s Republic of China
| | - Xiaofen Li
- Department of Psychiatry, Renmin Hospital of Wuhan University, Wuhan, People’s Republic of China
| | - Xuan Gong
- Department of Psychiatry, Renmin Hospital of Wuhan University, Wuhan, People’s Republic of China
| | - Zhongxiang Cai
- Department of Nursing, Renmin Hospital of Wuhan University, Wuhan, People’s Republic of China
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Yavuz BE, Turan S, Mutlu C, Çamlı ŞE. A comparison of the social cognition and neurocognitive characteristics of adolescents with suicide behavior, adolescent with depression and healthy controls. Suicide Life Threat Behav 2024; 54:785-797. [PMID: 38738815 DOI: 10.1111/sltb.13090] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/15/2024] [Revised: 03/31/2024] [Accepted: 04/18/2024] [Indexed: 05/14/2024]
Abstract
INTRODUCTION Deficits in neurocognition and social-cognition have been suggested to be an endophenotype for suicidal behavior. We aimed to compare the social-cognition and neurocognitive characteristics of adolescents diagnosed with depression with and without suicidal behavior and to investigate whether these functions predict suicide. METHOD Adolescents diagnosed with Major Depressive Disorder (MDD) with suicidal behavior (n = 42); MDD without suicidal behavior (n = 44) and age- and sex-matched controls (n = 43) were included. The University of Pennsylvania Computerized Neurobehavioral Test Battery and Autism Spectrum Screening Questionnaire (ASSQ) were used to evaluate social-cognition and neurocognitive characteristics. RESULTS Several neurocognitive domain values of MDD groups, were significantly different from the control group. Neutral emotion recognition task (p = 0.025) and ASSQ scores were found to be significantly impaired in the patient groups (p < 0.001). Logistic regression analysis showed that, only the increase in the Suicide Probability Scale score was found to be significant as a risk factor predicting suicide (p = 0.007, OR: 1.246). CONCLUSION While the neurocognitive and social-cognitive performances of adolescents with MDD were significantly lower than the control group, these performances in the two depression groups were similar. When the predictors of suicidal behavior were examined, it was found that only the increase in suicidal ideation scores predicted suicide.
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Affiliation(s)
- B Ece Yavuz
- Department of Child and Adolescent Psychiatry, TC Sağlık Bakanlığı Cizre Dr. Selahattin Cizrelioğlu Devlet Hastanesi, Şırnak, Turkey
| | - Serkan Turan
- Department ofChild and Adolescent Psychiatry, Faculty of Medicine, Bursa Uludag University, Bursa, Turkey
| | - Caner Mutlu
- Department ofChild and Adolescent Psychiatry, Faculty of Medicine, Bursa Uludag University, Bursa, Turkey
| | - Şafak Eray Çamlı
- Department ofChild and Adolescent Psychiatry, Faculty of Medicine, Bursa Uludag University, Bursa, Turkey
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Sack L, Seddon JA, Sosa-Hernandez L, Thomassin K. Typologies of Non-Suicidal Self-Injury Functions and Clinical Correlates Among Inpatient Youth. Child Psychiatry Hum Dev 2024; 55:999-1009. [PMID: 36350479 DOI: 10.1007/s10578-022-01465-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/24/2022] [Indexed: 11/11/2022]
Abstract
This study identified typologies of specific non-suicidal self-injury (NSSI) functions among youth admitted for psychiatric hospitalization and investigated clinically relevant correlates. Inpatient youth (n = 68) aged 10-17 years reported on their reasons to engage in NSSI, frequency and severity of NSSI, and symptoms of borderline personality disorder (BPD). A latent class analysis using youth's specific NSSI functions as indicators found two NSSI function typologies, which were differentially associated with clinical correlates. The Multiple Functions class (n = 28) endorsed to "feel something," "punish self," "escape feelings," "relieve anxiety," "stop feeling self-hatred," "stop feeling angry," "show much they are hurting," and "create a hurt that can be soothed." Conversely, the Single/Avoidant Function class (n = 40) endorsed one primary function-i.e., to "escape feelings." Youth in the Multiple Functions class reported significantly more frequent self-injury and greater BPD symptomology. The present study illustrates the importance of examining constellations of specific NSSI functions in inpatient care settings, given their unique associations with NSSI frequency and features of BPD. These findings could inform targeted psychological screening and, in turn, guide the implementation of interventions for elevated NSSI frequency and BPD symptomology among inpatient youth, based on NSSI functions endorsed.
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Affiliation(s)
- Leah Sack
- Department of Psychology, University of Guelph, 50 Stone Rd. E, Guelph, ON, N1G 1V4, Canada.
| | - Jessica A Seddon
- Department of Psychology, University of Guelph, 50 Stone Rd. E, Guelph, ON, N1G 1V4, Canada
| | | | - Kristel Thomassin
- Department of Psychology, University of Guelph, 50 Stone Rd. E, Guelph, ON, N1G 1V4, Canada
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Guo Y, Lu R, Ou Y, Huang Y, Li J, Cui Y, Li D, Zheng Y, Liang X, Qiu S, Liu Y. A study on the association between prefrontal functional connectivity and non-suicidal self-injury in adolescents with depression. Front Neurol 2024; 15:1382136. [PMID: 38711563 PMCID: PMC11070463 DOI: 10.3389/fneur.2024.1382136] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2024] [Accepted: 04/08/2024] [Indexed: 05/08/2024] Open
Abstract
Objective Among adolescents with depression, the occurrence of non-suicidal self-injury (NSSI) behavior is prevalent, constituting a high-risk factor for suicide. However, there has been limited research on the neuroimaging mechanisms underlying adolescent depression and NSSI behavior, and the potential association between the two remains unclear. Therefore, this study aims to investigate the alterations in functional connectivity (FC) of the regions in the prefrontal cortex with the whole brain, and elucidates the relationship between these alterations and NSSI behavior in adolescents with depression. Methods A total of 68 participants were included in this study, including 35 adolescents with depression and 33 healthy controls. All participants underwent assessments using the 17-item Hamilton Depression Rating Scale (17-HAMD) and the Ottawa Self-Harm Inventory. In addition, functional magnetic resonance imaging (fMRI) data of the participants' brains were collected. Subsequently, the FCs of the regions in the prefrontal cortex with the whole brain was calculated. The FCs showing significant differences were then subjected to correlation analyses with 17-HAMD scores and NSSI behavior scores. Result Compared to the healthy control group, the adolescent depression group exhibited decreased FCs in several regions, including the right frontal eye field, left dorsolateral prefrontal cortex, right orbitofrontal cortex, left insula and right anterior cingulate coetex. The 17-HAMD score was positively correlated with the frequency of NSSI behavior within 1 year (rs = 0.461, p = 0.005). The FC between the right anterior cingulate cortex and the right precuneus showed a negative correlation with the 17-HAMD scores (rs = -0.401, p = 0.023). Additionally, the FC between the right orbitofrontal cortex and the right insula, demonstrated a negative correlation with the frequency of NSSI behavior within 1 year (rs = -0.438, p = 0.012, respectively). Conclusion Adolescents with depression showed decreased FCs of the prefrontal cortex with multiple brain regions, and some of these FCs were associated with the NSSI frequency within 1 year. This study provided neuroimaging evidence for the neurophysiological mechanisms underlying adolescent depression and its comorbidity with NSSI behavior.
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Affiliation(s)
- Yan Guo
- First Clinical Medical College, Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, China
- State Key Laboratory of Traditional Chinese Medicine Syndrome, Guangzhou, China
- Army Medical Center (Daping Hospital), Army Medical University, Chongqing, China
| | - Ruoxi Lu
- First Clinical Medical College, Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, China
- State Key Laboratory of Traditional Chinese Medicine Syndrome, Guangzhou, China
| | - Yiwen Ou
- First Clinical Medical College, Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, China
| | - Yuxin Huang
- First Clinical Medical College, Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, China
| | - Jianyu Li
- First Clinical Medical College, Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, China
- State Key Laboratory of Traditional Chinese Medicine Syndrome, Guangzhou, China
- Department of Radiology, The First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Ying Cui
- Cerebropathy Center, The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Danian Li
- Cerebropathy Center, The First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Yanting Zheng
- First Clinical Medical College, Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, China
- Department of Radiology, The First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Xinyu Liang
- First Clinical Medical College, Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, China
- State Key Laboratory of Traditional Chinese Medicine Syndrome, Guangzhou, China
| | - Shijun Qiu
- First Clinical Medical College, Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, China
- State Key Laboratory of Traditional Chinese Medicine Syndrome, Guangzhou, China
- Department of Radiology, The First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Yujie Liu
- Department of Radiology, The First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China
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Gao Y, Wang Y, Wang Z, Ma M, Li H, Wang J, Liu J, Qian H, Zhu P, Xu X. Family intimacy and adaptability and non-suicidal self-injury: a mediation analysis. BMC Psychiatry 2024; 24:210. [PMID: 38500067 PMCID: PMC10946147 DOI: 10.1186/s12888-024-05642-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/06/2023] [Accepted: 02/27/2024] [Indexed: 03/20/2024] Open
Abstract
BACKGROUND Current research has been focusing on non-suicidal self-injury (NSSI) behaviors among adolescents with depression. Although family intimacy and adaptability are considered protective factors for NSSI, evidence supporting this relationship is lacking. OBJECTIVE This study aims to examine the mechanisms operating in the relationship between family intimacy and adaptability and NSSI behaviors among adolescents. METHODS A self-administered general demographic information questionnaire, the Behavioral Functional Assessment Scale for Non-Suicidal Self-Injury, the Family Intimacy and Adaptability Scale, the Connor-Davidson Resilience Scale, and the Self-Assessment of Depression Scale were distributed among adolescents with depression in three tertiary hospitals in Jiangsu Province. RESULTS The relationship between family intimacy and adaptability and NSSI was assessed among 596 adolescents with depression. The results revealed the following: (1) Family intimacy and adaptability were negatively correlated with NSSI behavior. (2) Psychological resilience and depression levels acted as chain mediators in the relationship between family intimacy and adaptability and NSSI behavior. CONCLUSIONS Enhancing psychological resilience, controlling depressive symptoms, and reducing depression severity among adolescents by improving their family intimacy and adaptability are conducive to preventing and mitigating their NSSI behaviors.
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Affiliation(s)
- Yuehong Gao
- The Fourth People's Hospital of Nantong, Nantong, China
| | - Yanchi Wang
- The Sixth People's Hospital of Nantong, Nantong, China
| | - Zhiping Wang
- The Fourth People's Hospital of Nantong, Nantong, China
| | - Mingzhen Ma
- The Fourth People's Hospital of Nantong, Nantong, China
| | | | - Jinhong Wang
- The Fourth People's Hospital of Nantong, Nantong, China
| | - Jianan Liu
- The Fourth People's Hospital of Nantong, Nantong, China
| | | | - Ping Zhu
- Suzhou Guangji Hospital, Su Zhou Shi, China
| | - Xujuan Xu
- Affiliated Hospital of Nantong University, Nantong, China.
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Suhail Usmani S, Mehendale M, Yousif Shaikh M, Sudan S, Guntipalli P, Ouellette L, Sajid Malik A, Siddiqi N, Walia N, Shah K, Saeed F, De Berardis D, Shoib S. Understanding the Impact of Adverse Childhood Experiences on Non-suicidal Self-Injury in Youth: A Systematic Review. ALPHA PSYCHIATRY 2024; 25:150-164. [PMID: 38798814 PMCID: PMC11117420 DOI: 10.5152/alphapsychiatry.2024.231139] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/27/2023] [Accepted: 01/24/2024] [Indexed: 05/29/2024]
Abstract
Objective Non-suicidal self-injury (NSSI), defined as a deliberate destruction of one's own body without a suicidal intent, is a global public health issue. Adverse childhood events (ACEs) have been shown to be associated with various mental illnesses; however, to date the impact of such events on NSSI in youth has not been reviewed. Methods We conducted a systematic review, searched 5 databases for published articles evaluating ACE and NSSI in youth less than or equal to 21 years of age. After screening 247 articles, we included 21 unique articles in this systematic review. Results Increasing ACE score, physical, sexual or emotional abuse, parental neglect and substance use, parental separation or dysfunctional family, and death of a close family member had statistically significant correlation with NSSI. Conclusion Non-suicidal self-injury is an impairing diagnosis with far reaching psychiatric manifestations and repercussions. Practitioners having high clinical suspicion for ACEs in youth with NSSI must intervene early by administering the ACEs questionnaire. Effective treatment of NSSI in those with ACEs with psychotherapy significantly improves outcomes and prevents suicide in youth.
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Affiliation(s)
- Sadia Suhail Usmani
- Department of Internal Medicine, Insight Hospital and Medical Center, Chicago, IL, USA
| | - Meghana Mehendale
- Department of Psychiatry, Smolensk State Medical University, Smolensk Oblast, Russia
| | - Mahnoor Yousif Shaikh
- Department of Psychiatry, Dow University of Health Sciences, Karachi, Sindh, Pakistan
| | - Sourav Sudan
- Department of Internal Medicine, Government Medical College, Baskshi Nagar, Jammu, Jammu and Kashmir, India
| | - Prathima Guntipalli
- Department of Internal Medicine, Texas Woman’s University, Southwestern Medical Ave., Dallas, TX, USA
| | - Lara Ouellette
- Department of Psychiatry, Texas Medical Center Library, Houston, TX, USA
| | - Anem Sajid Malik
- Department of Internal Medicine, King Edward Medical University, Nila Gumbad Chowk, Neela Gumbad, Lahore, Punjab, Pakistan
| | - Naila Siddiqi
- Department of Psychiatry, University of Toronto, Toronto, Canada
| | - Namrata Walia
- Department of Psychiatry, University of Texas Health Sciences Center, Houston, TX, USA
| | - Kaushal Shah
- Department of Psychiatry, Wake Forest University School of Medicine Program, Winston-Salem, NC, USA
- Department of Psychiatry, Oklahoma State University, Tulsa, OK, USA
- Department of Psychiatry, Griffin Memorial Hospital, Norman, OK, USA
| | - Fahimeh Saeed
- Department of Psychiatry, Psychosis Research Center, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | | | - Sheikh Shoib
- Department of Psychiatry, DH Pulwama, Kashmir, India
- Department of Psychiatry, Sharda University, Greater Noida, Uttar Pradesh, India
- Department of Psychiatry, Mind wellness Center, Nawab Bazar Srinagar, India
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Pollak OH, Kwon SJ, Jorgensen NA, Lindquist KA, Telzer EH, Prinstein MJ. Neural Reactivity to Social Punishment Predicts Future Engagement in Nonsuicidal Self-injury Among Peer-Rejected Adolescents. Biol Psychiatry 2023; 94:40-49. [PMID: 36411092 DOI: 10.1016/j.biopsych.2022.09.030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/06/2022] [Revised: 09/28/2022] [Accepted: 09/29/2022] [Indexed: 11/22/2022]
Abstract
BACKGROUND Rates of nonsuicidal self-injury (NSSI) increase dramatically in adolescence. Affective reactivity and adverse social experiences have been linked to NSSI, but less is known about whether these factors may separately or interactively predict NSSI, especially longitudinally. This study combined functional magnetic resonance imaging and a sociometric measure to test whether a combination of neural (e.g., amygdala) reactivity to social punishment and peer-nominated peer acceptance/rejection predicts NSSI longitudinally in adolescence. Amygdala reactivity was examined as a potential neural marker of affective reactivity to social punishment, which may heighten NSSI risk in contexts of social adversity. METHODS One hundred twenty-five adolescents (63 female) completed a social incentive delay task during neuroimaging and school-based peer nominations to measure peer acceptance/rejection. NSSI engagement was assessed at baseline and 1-year follow-up. RESULTS Greater amygdala reactivity to social punishment predicted greater NSSI engagement 1 year later among adolescents with high peer rejection. This effect for the amygdala was specific to social punishment (vs. reward) and held when controlling for biological sex and pubertal development. Exploratory analyses found that ventral striatum reactivity to social reward and punishment similarly interacted with peer rejection to predict NSSI but that amygdala connectivity with salience network regions did not. CONCLUSIONS Amygdala reactivity to social punishment, in combination with high peer rejection, may increase NSSI risk in adolescence, possibly via heightened affective reactivity to adverse social experiences. Objective measures of neurobiological and social risk factors may improve prediction of NSSI, while therapeutic approaches that target affective reactivity and increase prosocial skills may protect against NSSI in adolescence.
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Affiliation(s)
- Olivia H Pollak
- Department of Psychology and Neuroscience, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina.
| | - Seh-Joo Kwon
- Department of Psychology and Neuroscience, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Nathan A Jorgensen
- Department of Psychology and Neuroscience, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Kristen A Lindquist
- Department of Psychology and Neuroscience, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Eva H Telzer
- Department of Psychology and Neuroscience, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Mitchell J Prinstein
- Department of Psychology and Neuroscience, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
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Zhao K, Tong S, Hong L, Yang S, Yang W, Xu Y, Fan Z, Zheng J, Yao K, Zheng T. Childhood trauma, peer victimization, and non-suicidal self-injury among Chinese adolescents: a latent variable mediation analysis. BMC Psychiatry 2023; 23:436. [PMID: 37322505 PMCID: PMC10268482 DOI: 10.1186/s12888-023-04848-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/05/2023] [Accepted: 05/05/2023] [Indexed: 06/17/2023] Open
Abstract
BACKGROUND Childhood and peer experiences can influence adolescents' perceptions of interpersonal relationships, which can, in turn, influence their emotional states and behavior patterns. Non-suicidal self-injury (NSSI) is now a common problem behavior among adolescents. The present study examined the role of childhood trauma and peer victimization in adolescents' NSSI. METHODS A cross-sectional survey was conducted among 1783 adolescents (1464 girls and 318 boys) in the psychiatric outpatient clinics or wards of 14 psychiatric hospitals or general hospitals in nine provinces in China. Data were collected using the Multidimensional Peer Victimization Scale (MPVS), Short-form Childhood Trauma Questionnaire(CTQ-SF), and Functional Assessment of Self-Mutilation (FASM). Structural equation modeling (SEM) with latent variables was used to demonstrate the mediating role of peer victimization in the association between childhoodtrauma and NSSI. RESULTS The SEM analysis demonstrated that peer victimization plays a partial mediating role in the relationship between childhood trauma and NSSI. In addition, several covariates (such as age, gender, education level, and place of residence) effectively regulated the relationship between peer victimization and NSSI. CONCLUSION In future studies of NSSI among Chinese adolescents, attention should be paid to the roles of childhood trauma and peer bullying; there is a temporal sequence between these two variables and, to some extent, childhood trauma can have an impact on bullying during adolescence which, in turn, influences NSSI behavior.
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Affiliation(s)
- Ke Zhao
- Lishui Second People’s Hospital Afliated to Wenzhou Medical University, Lishui, 323000 China
- School of Mental Health, Wenzhou Medical University, Wenzhou, 325000 China
- The Affiliated Kangning Hospital of Wenzhou Medical University Zhejiang Provincial Clinical Research Center for Mental Disorder, Wenzhou, 325000 China
| | - Siyu Tong
- School of Mental Health, Wenzhou Medical University, Wenzhou, 325000 China
| | - Lan Hong
- The Third Hospital of Quzhou, Quzhou, 324000 China
| | - Shang Yang
- School of Mental Health, Wenzhou Medical University, Wenzhou, 325000 China
| | - Wenyun Yang
- School of Mental Health, Wenzhou Medical University, Wenzhou, 325000 China
| | - Yao Xu
- School of Mental Health, Wenzhou Medical University, Wenzhou, 325000 China
| | - Zilin Fan
- School of Mental Health, Wenzhou Medical University, Wenzhou, 325000 China
| | - Jiaqi Zheng
- School of Mental Health, Wenzhou Medical University, Wenzhou, 325000 China
| | - Keqing Yao
- Shenzhen Mental Health Center, Shenzhen, Guangdong China
- Shenzhen Kangning Hospital, 77 Zhenbi Road, Pingshan District, Shenzhen, Guangdong 518118 China
| | - Tiansheng Zheng
- The Affiliated Kangning Hospital of Wenzhou Medical University Zhejiang Provincial Clinical Research Center for Mental Disorder, Wenzhou, 325000 China
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10
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Sarfo JO, Obeng P, Debrah TP, Gbordzoe NI, Fosu AK. Suicidal behaviours (ideation, plan and attempt) among school-going adolescents: A study of prevalence, predisposing, and protective factors in Saint Vincent and the Grenadines. DIALOGUES IN HEALTH 2022; 1:100077. [PMID: 38515915 PMCID: PMC10954014 DOI: 10.1016/j.dialog.2022.100077] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/14/2022] [Revised: 11/08/2022] [Accepted: 11/08/2022] [Indexed: 03/23/2024]
Abstract
Suicide occurs throughout life and is among the leading causes of death among adolescents globally. Aside from the growing literature on this serious mental health issue, little is known about the prevalence of suicide and the variables that predispose and protect adolescents against it in Saint Vincent and the Grenadines. We analysed the Global School-based Student Health Survey data collection among school-going adolescents in Saint Vincent and the Grenadines to explore the prevalence, risk and protective variables associated with suicidal behaviours. We observed prevalence rates of 26%, 26%, and 19% for suicide ideation, plan, and attempt, respectively. Furthermore, sex (being male) and having parents or guardians who understand the problems and worries of adolescents served as protective factors against all three suicide behaviours. However, we observed truancy, cigarette smoking, bullying victims (on/off school property), being cyberbullied, loneliness, and worry as risk factors for suicide ideation among adolescents. Risk for suicide plan was predicted by truancy, cigarette smoking, physical fight, bullying victims (on/off school property), being cyberbullied, loneliness, and worry. After controlling for other factors, truancy, amphetamine or methamphetamine use, cigarette smoking, physical fight, bullying victims (on/off school property), serious injury, close friends, loneliness, and worrying about life issues predicted suicide attempt risk among adolescents in Saint Vincent and the Grenadines. Early identification and suicide prevention interventions focusing on identified protective and risk factors may help minimise the prevalence of suicide behaviours among school-going adolescents in Saint Vincent and the Grenadines.
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Psycho-Behavioral Profiles of Pediatric Inpatients with Past and Recent Onset of Nonsuicidal Self-Injury: A Cluster Analysis Approach. J Clin Med 2022; 11:jcm11154602. [PMID: 35956216 PMCID: PMC9369878 DOI: 10.3390/jcm11154602] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2022] [Revised: 08/02/2022] [Accepted: 08/05/2022] [Indexed: 11/24/2022] Open
Abstract
Few studies have focused on the persistence of nonsuicidal self-injury (NSSI) over time in developmental age. This study aimed to define the psycho-behavioral profiles of young inpatients according to past or recent NSSI onset (i.e., NSSI for more or less than one year, respectively), and identify possible risk factors for maintaining NSSI over time. A total of 118 Italian NSSI inpatients aged 9–17 were involved. The Youth Self-Report (YSR) was administered. K-means cluster analyses were conducted using the YSR affective disorders, social competencies, and social problems scales as clustering variables. A binomial logistic regression was run to clarify which of these variables discriminate between the past and recent NSSI onset groups. Chi-square tests were performed to pinpoint the variables associated with long-standing NSSI. The final cluster solution displayed four psycho-behavioral profiles; a greater number of inpatients with recent NSSI onset was found in the clusters characterized by scarce social competencies. Affective disorders and social competencies were significant predictors, and higher scores on both scales were more likely in the past NSSI onset group. School problems and alcohol/substance use were related to long-standing NSSI. Therefore, a lack of social skills may be involved in recent NSSI onset, while affective disorders and other problem behaviors may dictate the continuation of NSSI over time.
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12
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Schwartz-Lifshitz M, Ben-Dor DH, Bustan Y, Zalsman G, Gothelf D, Weizman A, Barzilay R. Phenotypic Characterization of Youth Admitted To Acute Psychiatric Inpatient Unit Following Self-Harm Behavior. Arch Suicide Res 2022; 26:1186-1197. [PMID: 33403931 PMCID: PMC9534345 DOI: 10.1080/13811118.2020.1865223] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
OBJECTIVE Deliberate self-harm (DSH) is a major health concern among adolescents, and is often associated with the need for inpatient psychiatric hospitalization. The aim of this study was to identify clinical and demographic characteristics associated with DSH behavior among adolescents admitted to an acute psychiatric inpatient unit. METHOD We retrospectively analyzed data from the electronic medical records of consecutive admittances to a single acute adolescent inpatient unit (n = 703, mean age 15.2). We compared inpatients with DSH to inpatients without DSH and further compared within the DSH group based on the presence of suicidal intent. RESULTS Compared to Non-DSH inpatients (n = 497), youths admitted following DSH (n = 206) were more likely to be female (OR = 2.6, 95%CI 1.7-4), currently in depressive exacerbation (OR = 2.4, 95%CI 1.6-3.6), with concurrent suicidal ideation (OR = 3.9, 95%CI 2.5-5.9), and history of alcohol use (OR = 5.6, 95%CI 3.2-9.5). Within DSH youths, no significant clinical differences were identified between those admitted following a suicide attempt (n = 102) compared to non-suicidal-self-injury (n = 104), who were generally younger. CONCLUSIONS Findings suggest that early detection and intervention of DSH and depressive crisis is warranted, regardless of the self-harm subtype.HIGHLIGHTSDeliberate self-harm is common among adolescent psychiatric inpatients.Adolescent inpatients with deliberate self-harm are predominantly females with concurrent depression and suicidal ideation.We did not detect significant clinical and demographic differences between self-harmers with or without suicidal intent.
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13
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Forbes CN, Tull MT, Chapman AL, Dixon-Gordon KL, Gratz KL. Implicit Associations of Nonsuicidal Self-Injury with Relief in Posttraumatic Stress and Depressive Disorders. Arch Suicide Res 2022; 26:565-580. [PMID: 32866425 DOI: 10.1080/13811118.2020.1811182] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
OBJECTIVE Although once considered a defining feature of borderline personality disorder, research has found high rates of NSSI among individuals with other psychiatric disorders, particularly posttraumatic stress disorder (PTSD) and depressive disorders. A recent study from our research team found that lifetime PTSD and depressive disorders were associated with unique self-reported NSSI motives. Given well-established limitations of assessing motives via self-report measures, the present study sought to extend this line of research by using a novel laboratory measure of the implicit NSSI-relief association to examine NSSI emotional relief motives. METHOD A subset of participants from our previous study (N = 109) completed diagnostic interviews and the laboratory-based DSH-Relief Implicit Association Test (IAT). RESULTS Findings indicated that individuals with lifetime PTSD evidenced stronger NSSI-relief associations than those without PTSD. Further, this main effect was qualified by a PTSD by depressive disorder interaction, such that stronger NSSI-relief associations were found among individuals with lifetime PTSD but no lifetime depressive disorder than among individuals without a history of either PTSD or a depressive disorder. CONCLUSIONS Results highlight the importance of investigating NSSI motives associated with different symptom profiles using a multi-method approach.
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14
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Yang F, Jiang L, Miao J, Xu X, Ran H, Che Y, Fang D, Wang T, Xiao Y, Lu J. The association between non-suicidal self-injury and negative life events in children and adolescents in underdeveloped regions of south-western China. PeerJ 2022; 10:e12665. [PMID: 35287346 PMCID: PMC8917796 DOI: 10.7717/peerj.12665] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2021] [Accepted: 11/30/2021] [Indexed: 01/07/2023] Open
Abstract
Background The association between negative life events and Non-suicidal self-injury (NSSI) in children and adolescents has been extensively discussed. Nevertheless, little is known about the relationship between negative life events and repetition and severity of NSSI. This survey aims to understand the association between NSSI prevalence, severity, repetition and the negative life events in children and adolescents in underdeveloped regions in south-western China. Methods In this population-based cross-sectional study, 3,146 children and adolescents were included from underdeveloped regions of south-western China, and each of them requested to complete a self-assessment questionnaire. The Modified Version of Adolescents Self-Harm Scale (MASHS) and the Adolescent Self-rating negative Life Events Check-list were used to evaluate NSSI behaviors and negative life events, respectively. The statistical implementation of this study was carried out in the R statistical software, and the logistic regression analysis method was used to analyze the relationship between negative life events and adolescents' non-suicidal self-injury behaviors. Results The average age of all included participants was 13.31 years old. The lifetime prevalence of NSSI was 47.0% (95% CI [36.3-58.0%]). Gender, grade level and ASLEC was positively associated with NSSI. Further analysis revealed that, for all five dimensions of ASLEC, only interpersonal relationship factor (IRF) (OR 1.77 (95% CI [1.06-2.97])), health adaptation factor (HAF) (OR 2.08 (95% CI [1.31-3.31])) showed prominent association with NSSI. Multivariate Logistic regression models revealed that, repetitive NSSI (OR 4.54 (95% CI [3.66-5.63])) and NSSI severity (OR 9.01 (95% CI [6.11-13.29])) were positively associated with ASLEC. Conclusion NSSI is very common among children and adolescents in underdeveloped regions of south-western China. Negative life event are positively associated with NSSI, repeated NSSI, and severe NSSI. Negative life events centered intervention measures might be effective in reducing NSSI among school children and adolescents in underdeveloped regions of south-western China.
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Affiliation(s)
- Fan Yang
- First Affiliated Hospital of Kunming Medical University, Psychiatric Department, Kunming, Yunnan, China
| | - Linling Jiang
- First Affiliated Hospital of Kunming Medical University, Psychiatric Department, Kunming, Yunnan, China
| | - Jing Miao
- First Affiliated Hospital of Kunming Medical University, Psychiatric Department, Kunming, Yunnan, China
| | - Xiufeng Xu
- First Affiliated Hospital of Kunming Medical University, Psychiatric Department, Kunming, Yunnan, China
| | - Hailiang Ran
- Kunming Medical University, School of Public Health, Kunming, Yunnan, China
| | - Yusan Che
- Kunming Medical University, School of Public Health, Kunming, Yunnan, China
| | - Die Fang
- Kunming Medical University, School of Public Health, Kunming, Yunnan, China
| | - TianLan Wang
- Lincang Psychiatric Hospital, Lincang, Yunnan, China
| | - Yuanyuan Xiao
- Kunming Medical University, School of Public Health, Kunming, Yunnan, China
| | - Jin Lu
- First Affiliated Hospital of Kunming Medical University, Psychiatric Department, Kunming, Yunnan, China
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15
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Park SJ, Rim SJ, Jo M, Lee MG, Kim G, Park S. Self-Injurious Behavior Rate in the Short-Term Period of the COVID-19 Pandemic in Korea. J Korean Med Sci 2022; 37:e45. [PMID: 35166081 PMCID: PMC8845102 DOI: 10.3346/jkms.2022.37.e45] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/14/2021] [Accepted: 12/30/2021] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND The objective of this study was to investigate the trend of self-injurious behavior (SIB) among persons who were directly impacted by coronavirus disease 2019 (COVID-19), especially those with pre-existing mental disorders. METHODS Using the National Health Insurance Service-COVID-19 database cohort, the monthly SIB rate was calculated by COVID-19 subgroups (i.e., positive for COVID-19 test, negative for COVID-19 test, and non-COVID-19 test [control]). In addition, moderated regression analysis was utilized to examine the statistical difference of SIB (suicide attempt and non-suicidal self-injury using ICD-10 code) trend between COVID-19 subgroups and with and without pre-existing mental disorder. RESULTS A total of 328,373 persons were included in the cohort study. Of these, 212,678 had been tested for COVID-19, and 7,713 of them were confirmed positive. During the pandemic peak, the "negative for COVID-19" group showed a large increase (P = 0.003) in SIB rates compared to the control group, the "positive for COVID-19" group showed a decreasing trend, but not significant (P = 0.314). Among those who were tested for COVID-19, those with pre-existing mental disorders showed an increasing trend of SIB compared to those without pre-existing mental disorders, however statistically insignificant (P = 0.137). CONCLUSION Our results suggest that people who are tested for COVID-19 are at a high risk of SIB during the peak COVID-19 pandemic. Therefore, screening for suicide risk and psychological interventions is needed for these high-risk groups.
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Affiliation(s)
- Se Jin Park
- Department of Research Planning, Mental Health Research Institute, National Center for Mental Health, Seoul, Korea
| | - Soo Jung Rim
- Department of Research Planning, Mental Health Research Institute, National Center for Mental Health, Seoul, Korea
| | - Minkyung Jo
- Department of Research Planning, Mental Health Research Institute, National Center for Mental Health, Seoul, Korea
| | - Min Geu Lee
- Department of Research Planning, Mental Health Research Institute, National Center for Mental Health, Seoul, Korea
| | - Gyurin Kim
- Department of Research Planning, Mental Health Research Institute, National Center for Mental Health, Seoul, Korea
| | - Subin Park
- Mental Health Research Institute, National Center for Mental Health, Seoul, Korea.
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16
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Zhang Y, Lai S, Wu W, Wang Y, Zhao H, He J, Zhu Y, Chen G, Qi Z, Chen P, Lv S, Song Z, Hu Y, Miao H, Yan S, Luo Y, Ran H, Huang X, Lu X, Zhong S, Jia Y. Associations between executive function impairment and biochemical abnormalities in depressed adolescents with non-suicidal self-injury. J Affect Disord 2022; 298:492-499. [PMID: 34737017 DOI: 10.1016/j.jad.2021.10.132] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/19/2021] [Revised: 10/26/2021] [Accepted: 10/29/2021] [Indexed: 12/09/2022]
Abstract
BACKGROUND H protons magnetic resonance spectroscopy (1H-MRS) has been used to detect the biochemical metabolism changes and the mechanism of executive dysfunction in major depressive disorder (MDD). While, finding information associated with non-suicidal self-injury (NSSI) among adolescents with MDD is challenging. The present study aimed to examine the executive function and biochemical metabolism alterations, as well as to elucidate their associations in depressed adolescents with NSSI. METHODS A total of 86 adolescents with MDD (40 with NSSI, and 46 without NSSI) and 28 healthy controls were recruited in the current study. The executive function was assessed by Digital symbol test (DST), Wisconsin Card Sorting Test (WCST), Trail Making Test, part B (TMT-B), and Verbal fluency (VF). Bilateral metabolite levels of the prefrontal cortex (PFC), anterior cingulated cortex (ACC), lenticular nucleus (LN) of basal ganglia and thalamus were obtained by 1H-MRS at 3.0 T, and then the ratios of N-acetyl aspartate (NAA) and choline-containing compounds (Cho) to creatine (Cr) were determined, respectively. Finally, association analysis was conducted to investigate their relationships. RESULTS The depressed adolescents with NSSI showed significantly lower VF scores than those without NSSI and healthy controls. We also found significantly higher NAA/Cr ratios in the right thalamus, while significantly lower Cho/Cr ratios in the right thalamus of NSSI group than the MDD without NSSI group and healthy controls. And NSSI group also showed lower NAA/Cr ratio in the right LN than the MDD without NSSI group. For MDD with NSSI, the NAA/Cr ratios of the left thalamus were positively correlated with the time of TMTB and the Cho/Cr ratios of the left ACC were positively correlated with the VF scores. CONCLUSIONS Depressed adolescents with NSSI may have executive dysfunction and NAA and Cho metabolism abnormalities in the thalamus. And the NAA/Cr ratios of the right LN could distinguish NSSI from depressed adolescents. Further, the executive dysfunction may be associated with the abnormal NAA metabolism in the left thalamus and ACC.
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Affiliation(s)
- Yiliang Zhang
- Department of Psychiatry, First Affiliated Hospital of Jinan University, Guangzhou 510630, China
| | - Shunkai Lai
- Department of Psychiatry, First Affiliated Hospital of Jinan University, Guangzhou 510630, China
| | - Weige Wu
- Department of Psychiatry, First Affiliated Hospital of Jinan University, Guangzhou 510630, China; The Department of Child and Adolescent Psychology Xiamen Xianyue hospital, Fujian 361012, China
| | - Ying Wang
- Medical Imaging Center, First Affiliated Hospital of Jinan University, Guangzhou 510630, China
| | - Hui Zhao
- Department of Psychiatry, First Affiliated Hospital of Jinan University, Guangzhou 510630, China
| | - Jiali He
- Department of Psychiatry, First Affiliated Hospital of Jinan University, Guangzhou 510630, China
| | - Yunxia Zhu
- Department of Psychiatry, First Affiliated Hospital of Jinan University, Guangzhou 510630, China
| | - Guangmao Chen
- Medical Imaging Center, First Affiliated Hospital of Jinan University, Guangzhou 510630, China
| | - Zhangzhang Qi
- Medical Imaging Center, First Affiliated Hospital of Jinan University, Guangzhou 510630, China
| | - Pan Chen
- Medical Imaging Center, First Affiliated Hospital of Jinan University, Guangzhou 510630, China
| | - Sihui Lv
- School of Management, Jinan University, Guangzhou 510316, China
| | - Zijin Song
- School of Management, Jinan University, Guangzhou 510316, China
| | - Yilei Hu
- School of Management, Jinan University, Guangzhou 510316, China
| | - Haofei Miao
- School of Management, Jinan University, Guangzhou 510316, China
| | - Shuya Yan
- School of Management, Jinan University, Guangzhou 510316, China
| | - Yange Luo
- School of Management, Jinan University, Guangzhou 510316, China
| | - Hanglin Ran
- School of Management, Jinan University, Guangzhou 510316, China
| | - Xiaosi Huang
- Department of Psychiatry, First Affiliated Hospital of Jinan University, Guangzhou 510630, China
| | - Xiaodan Lu
- Department of Psychiatry, First Affiliated Hospital of Jinan University, Guangzhou 510630, China
| | - Shuming Zhong
- Department of Psychiatry, First Affiliated Hospital of Jinan University, Guangzhou 510630, China.
| | - Yanbin Jia
- Department of Psychiatry, First Affiliated Hospital of Jinan University, Guangzhou 510630, China.
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17
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Ye Z, Xiong F, Li W. A meta-analysis of co-occurrence of non-suicidal self-injury and suicide attempt: Implications for clinical intervention and future diagnosis. Front Psychiatry 2022; 13:976217. [PMID: 36032240 PMCID: PMC9411747 DOI: 10.3389/fpsyt.2022.976217] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/23/2022] [Accepted: 07/22/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Non-suicidal self-injury (NSSI) and suicide attempt (SA) are risk behaviors that lead to physical injury and even death in individuals, and are a very powerful risk factor when both occur together, with individuals presenting with more severe psychological and behavioral problems. Due to the different demographic characteristics of different study subjects, an overall understanding of the incidence and occurrence of this co-occurrence is lacking to clarify the focus of clinical interventions and future research directions. METHODS A systematic search was conducted for relevant studies in English and Chinese that reported data on co-occurring non-suicidal self-injury and suicide attempts as of May 2022. The incidence of co-occurrence of non-suicidal self-injury and suicide attempt (NSSI + SA) was calculated using Stata version 16.0 software based on a random-effects model, and the differences in incidence in different populations were compared by subgroups of age group, comorbidity, and time of occurrence. The study was written in strict accordance with PRISMA norms and registration was completed on the PROSPERO platform (CRD42022329095). RESULTS A total of 37 studies (139,573 individuals) were included for meta-analysis, and the combined incidence of non-suicidal self-injury and suicide attempt co-occurrence was 9.6%. Among different groups, the prevalence of NSSI + SA was 10, 11, 6, and 26% in adolescents and young adults, adults, the general population, and people with mental illness, respectively, and the co-occurrence of NSSI + SA within 12 months was 17%. CONCLUSION There is a significant group with a history of both non-suicidal self-injury and suicide attempts and presenting with more severe symptoms clinically. Targeted prevention and intervention are urgently needed, but the direction of intervention needs further research on the occurrence trajectory of this co-occurrence. SYSTEMATIC REVIEW REGISTRATION http://www.crd.york.ac.uk/PROSPERO/display_record.asp?ID=CRD42022329095, identifier: CRD42022329095.
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Affiliation(s)
- Zhiyu Ye
- School of Education Research, China University of Geosciences, Wuhan, China.,Research Center for Psychological and Health Sciences, China University of Geosciences, Wuhan, China
| | - Fang Xiong
- School of Education Research, China University of Geosciences, Wuhan, China.,Research Center for Psychological and Health Sciences, China University of Geosciences, Wuhan, China
| | - Wentian Li
- Wuhan Mental Health Centre, Wuhan, China
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18
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Moller CI, Cotton SM, Badcock PB, Hetrick SE, Berk M, Dean OM, Chanen AM, Davey CG. Relationships Between Different Dimensions of Social Support and Suicidal Ideation in Young People with Major Depressive Disorder. J Affect Disord 2021; 281:714-720. [PMID: 33234284 DOI: 10.1016/j.jad.2020.11.085] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/08/2020] [Revised: 09/08/2020] [Accepted: 11/08/2020] [Indexed: 12/30/2022]
Abstract
BACKGROUND Suicidal ideation (SI) is a common feature of depression and is closely associated with suicidal behaviour. Social support is implicated as an important determinant of suicide, but it is unclear how different social support dimensions influence SI in young people with depression. This study examines relationships between social support dimensions and SI in young people with major depressive disorder (MDD). METHODS 283 Australians aged 15-25, diagnosed with MDD, were recruited from two clinical trials conducted in youth-specific outpatient mental health services. The Multidimensional Scale of Perceived Social Support (MSPSS) was used to evaluate perceived support from Family, Friends, and a Significant Other. Suicidal ideation was assessed using the Suicidal Ideation Questionnaire (SIQ). Hierarchical regression was used to explore associations between social support and SI, controlling for demographics and depression severity. RESULTS A hierarchical regression model predicted 9% of the variability in SI, with depression severity being the most significant predictor. Family Support was inversely related to SI and uniquely contributed 2% of the variance; β = -0.15 (95% CI -0.27 - -0.02) p < .05. Demographics and support from Friends or a Significant Other were not significantly associated with SI. LIMITATIONS Findings are correlational; it cannot be determined that increasing family support would decrease SI severity. CONCLUSION Perceived Family Support was negatively associated with SI in young people with MDD. This suggests that family members might play important roles in suicide prevention efforts. More work is needed exploring ways to empower families to develop adaptive family functioning and support.
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Affiliation(s)
- Carl I Moller
- Centre for Youth Mental Health, The University of Melbourne, Parkville, Victoria, Australia; Orygen, Parkville, Victoria, Australia.
| | - Sue M Cotton
- Centre for Youth Mental Health, The University of Melbourne, Parkville, Victoria, Australia; Orygen, Parkville, Victoria, Australia
| | - Paul B Badcock
- Centre for Youth Mental Health, The University of Melbourne, Parkville, Victoria, Australia; Orygen, Parkville, Victoria, Australia; Melbourne School of Psychological Sciences, The University of Melbourne, Parkville, Victoria, Australia
| | - Sarah E Hetrick
- Centre for Youth Mental Health, The University of Melbourne, Parkville, Victoria, Australia; Orygen, Parkville, Victoria, Australia; Department of Psychological Medicine, University of Auckland, Auckland, New Zealand
| | - Michael Berk
- Deakin University, IMPACT - the Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Barwon Health, Geelong, Australia; Florey Institute for Neuroscience and Mental Health and the Department of Psychiatry, The University of Melbourne, Melbourne, Australia
| | - Olivia M Dean
- Deakin University, IMPACT - the Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Barwon Health, Geelong, Australia; Florey Institute for Neuroscience and Mental Health and the Department of Psychiatry, The University of Melbourne, Melbourne, Australia
| | - Andrew M Chanen
- Centre for Youth Mental Health, The University of Melbourne, Parkville, Victoria, Australia; Orygen, Parkville, Victoria, Australia
| | - Christopher G Davey
- Centre for Youth Mental Health, The University of Melbourne, Parkville, Victoria, Australia; Orygen, Parkville, Victoria, Australia; Department of Psychiatry, The University of Melbourne, Parkville, Victoria, Australia
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19
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Ougrin D, Corrigall R, Stahl D, Poole J, Zundel T, Wait M, Slater V, Reavey P, Byford S, Ivens J, Crommelin M, Hayes D, Middleton K, Young P, Taylor E. Supported discharge service versus inpatient care evaluation (SITE): a randomised controlled trial comparing effectiveness of an intensive community care service versus inpatient treatment as usual for adolescents with severe psychiatric disorders: self-harm, functional impairment, and educational and clinical outcomes. Eur Child Adolesc Psychiatry 2021; 30:1427-1436. [PMID: 32885344 PMCID: PMC8440265 DOI: 10.1007/s00787-020-01617-1] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/02/2020] [Accepted: 08/04/2020] [Indexed: 10/24/2022]
Abstract
Clinical guidelines recommend intensive community care service treatment (ICCS) to reduce adolescent psychiatric inpatient care. We have previously reported that the addition of ICCS led to a substantial decrease in hospital use and improved school re-integration. The aim of this study is to undertake a randomised controlled trial (RCT) comparing an inpatient admission followed by an early discharge supported by ICCS with usual inpatient admission (treatment as usual; TAU). In this paper, we report the impact of ICCS on self-harm and other clinical and educational outcomes. 106 patients aged 12-18 admitted for psychiatric inpatient care were randomised (1:1) to either ICCS or TAU. Six months after randomisation, we compared the two treatment arms on the number and severity of self-harm episodes, the functional impairment, severity of psychiatric symptoms, clinical improvement, reading and mathematical ability, weight, height and the use of psychological therapy and medication. At six-month follow-up, there were no differences between the two groups on most measures. Patients receiving ICCS were significantly less likely to report multiple episodes (five or more) of self-harm (OR = 0.18, 95% CI: 0.05-0.64). Patients admitted to private inpatient units spent on average 118.4 (95% CI: 28.2-208.6) fewer days in hospitals if they were in the ICCS group compared to TAU. The addition of ICCS to TAU may lower the risk of multiple self-harm and may reduce the duration of inpatient stay, especially in those patients admitted for private care. Early discharge with ICCS appears to be a viable alternative to standard inpatient treatment.
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Affiliation(s)
- Dennis Ougrin
- grid.13097.3c0000 0001 2322 6764King’s College London, London, UK
| | | | - Daniel Stahl
- grid.13097.3c0000 0001 2322 6764King’s College London, London, UK
| | - Jason Poole
- grid.13097.3c0000 0001 2322 6764King’s College London, London, UK
| | - Toby Zundel
- grid.13097.3c0000 0001 2322 6764King’s College London, London, UK
| | - Mandy Wait
- grid.13097.3c0000 0001 2322 6764King’s College London, London, UK
| | - Victoria Slater
- grid.13097.3c0000 0001 2322 6764King’s College London, London, UK
| | - Paula Reavey
- grid.13097.3c0000 0001 2322 6764King’s College London, London, UK
| | - Sarah Byford
- grid.13097.3c0000 0001 2322 6764King’s College London, London, UK
| | - John Ivens
- grid.13097.3c0000 0001 2322 6764King’s College London, London, UK
| | | | - Daniel Hayes
- grid.13097.3c0000 0001 2322 6764King’s College London, London, UK
| | - Kerry Middleton
- grid.13097.3c0000 0001 2322 6764King’s College London, London, UK
| | | | - Eric Taylor
- grid.13097.3c0000 0001 2322 6764King’s College London, London, UK
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20
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Du N, Ouyang Y, Xiao Y, Li Y. Psychosocial Factors Associated With Increased Adolescent Non-suicidal Self-Injury During the COVID-19 Pandemic. Front Psychiatry 2021; 12:743526. [PMID: 34955911 PMCID: PMC8703160 DOI: 10.3389/fpsyt.2021.743526] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/18/2021] [Accepted: 11/12/2021] [Indexed: 11/13/2022] Open
Abstract
Non-suicidal self-injury (NSSI) in adolescents hospitalized with psychiatric disorders continues to increase after the outbreak of COVID-19. This study aimed to explore the relationship between the pandemic and NSSI among adolescents and whether the composition of psychosocial factors related to NSSI has changed during the pandemic. Through the retrospective analysis of medical records retrieved from the electronic system of the psychiatric hospital located in Chengdu from January 2016 to March 2021, 609 medical records of adolescents were obtained. The main potential psychosocial factors were determined by deductive content analysis. Among the 609 adolescents, 420 subjects had engaged in NSSI, while 189 did not. We found that the percentage of adolescents who had engaged in NSSI in 2016 was only 29.2%, reaching 34.5% in 2017, 45.7% in 2018, 61.3% in 2019, 92.5% in 2020, and 95.9% in 2021. In the binary logistic regression model, female sex (OR = 0.073, 95% CI: 0.028-0.186), older age (OR = 1.234, 95% CI: 1.030-1.478), having a single parent (OR = 7.865, 95% CI: 3.997-15.476), having experienced trauma (OR = 2.192, 95% CI: 1.032-4.654), having experienced social isolation from peers (OR = 8.139, 95% CI: 4.037-16.408), having experienced body-focused bullying (OR = 3.078, 95% CI: 1.295-7.318), overuse of a mobile phone in the parents' opinions (OR = 4.354, 95% CI: 1.380-13.738), having attempted suicide (OR = 9.120, 95% CI: 4.492-18.512), and during the pandemic (time point is January 30, 2020) (OR = 5.399, 95% CI: 1.679-17.357) were the factors that were significantly associated with NSSI. When comparing the differences in psychosocial factors between the pre-pandemic and the during-pandemic groups, the results showed that the family constitution, parent-child relationships, mobile phone overuse, and stressful learning were important factors. Tailored interventions geared towards changed psychosocial factors should be formulated.
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Affiliation(s)
- Na Du
- Clinical Psychology Department, The Fourth People's Hospital of Chengdu, Chengdu, China
| | - Yingjie Ouyang
- Clinical Psychology Department, The Fourth People's Hospital of Chengdu, Chengdu, China
| | - Yu Xiao
- Clinical Psychology Department, The Fourth People's Hospital of Chengdu, Chengdu, China
| | - Yunge Li
- Clinical Psychology Department, The Fourth People's Hospital of Chengdu, Chengdu, China
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21
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Simone AC, Hamza CA. Examining the disclosure of nonsuicidal self-injury to informal and formal sources: A review of the literature. Clin Psychol Rev 2020; 82:101907. [DOI: 10.1016/j.cpr.2020.101907] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2020] [Revised: 08/07/2020] [Accepted: 08/21/2020] [Indexed: 11/27/2022]
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22
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Moreira ÉDS, Vale RRMD, Caixeta CC, Teixeira RAG. Automutilação em adolescentes: revisão integrativa da literatura. CIENCIA & SAUDE COLETIVA 2020; 25:3945-3954. [DOI: 10.1590/1413-812320202510.31362018] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2018] [Accepted: 01/22/2019] [Indexed: 11/22/2022] Open
Abstract
Resumo Trata-se de uma revisão integrativa da literatura acerca dos conhecimentos produzidos pela comunidade científica sobre automutilação em adolescentes no período de janeiro de 2012 a junho de 2017. A busca foi realizada nas bases de dados SCIELO e Portal CAPES, em português, inglês e espanhol com amostra final de 71 artigos. Este estudo mostrou grande número de publicações a nível internacional, com destaque para artigos epidemiológicos e fragilidade na publicação de estudos de intervenção que investiguem a eficácia de terapias e programas de prevenção.
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23
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Hatkevich C, Venta A, Sharp C. Theory of mind and suicide ideation and attempt in adolescent inpatients. J Affect Disord 2019; 256:17-25. [PMID: 31158712 DOI: 10.1016/j.jad.2019.05.051] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/06/2018] [Revised: 04/04/2019] [Accepted: 05/27/2019] [Indexed: 10/26/2022]
Abstract
BACKGROUND Suicide ideation and attempt are alarmingly prevalent in adolescents, and even more so for youth in psychiatric settings. Interpersonal factors have been emphasized as important in the etiology and maintenance of suicide ideation and attempt in adolescents. Evaluating social cognitive deficits offers important insight into processes underlying interpersonal problems associated with suicide ideation and attempt; however little social-cognitive research has been conducted in this area. The aim of the current study was to explore the relation of theory of mind (ToM) impairments and suicide ideation and attempt among adolescent inpatients. METHODS A sample of 391 adolescent inpatients completed measures on ToM, suicidal ideation and attempt, clinical symptoms and sociodemographics. RESULTS Binary logistic regression analyses revealed significant relations between excessive ToM (hypermentalizing) and two suicide outcome variables (suicide ideation in the past four weeks, suicide attempt in the past year), while covarying for sociodemographics and multiple clinical symptom scales. CONCLUSIONS Excessive ToM, or over-attributing the mental/emotional states of others, appears to share a salient relation to recent suicidal thoughts and behavior in adolescent inpatients. Current findings may indicate that interventions incorporating social cognitive components (e.g., Mentalization Based Therapy and Cognitive Behavioral Therapy) may be of promise to treating youth with suicidal thoughts and behaviors and excessive ToM. LIMITATIONS The current study uses cross-sectional data and discrepancies exist in time periods assessed by primary measures.
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Affiliation(s)
- Claire Hatkevich
- Department of Psychiatry, University of Michigan/Michigan Medicine, Ann Arbor, MI, United States of America
| | - Amanda Venta
- Department of Psychology, Sam Houston State University, Huntsville, TX, United States of America
| | - Carla Sharp
- Department of Psychology, University of Houston, Houston, TX, United States of America.
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24
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Research on Relationships between Sexual Identity, Adverse Childhood Experiences and Non-Suicidal Self-Injury among Rural High School Students in Less Developed Areas of China. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16173158. [PMID: 31470648 PMCID: PMC6747706 DOI: 10.3390/ijerph16173158] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/19/2019] [Revised: 08/22/2019] [Accepted: 08/28/2019] [Indexed: 11/16/2022]
Abstract
Purpose: The objective of this study was to examine the influence of sexual identity and adverse childhood experiences (ACEs) on non-suicidal self-injury (NSSI) among rural high school students in less developed areas of China. Methods: Behavior risk factors data collected from 1810 students from a high school in Jiangxi province, China. Five measures of childhood abuse and household dysfunction were summarized, and ACE was divided into 0, 1, 2, 3–5 ACEs. Logistic regression analysis was used to explore the influence of sexual identity, adverse childhood experiences, and their interaction with non-suicidal self-injury. Results: Compared with heterosexual students, high school students who identify as lesbian, gay, or bisexual (LGB) have a higher tendency of non-suicidal self-injury (AOR = 3.250, 95% CI = 1.69–6.28, p < 0.01). There was also a graded relationship between cumulative ACEs exposure and non-suicidal self-injury behaviors (AOR = 1.627, 95% CI = 1.02–2.60, p < 0.05). Odds for NSSI are higher among students with both experienced ACEs and identified as LGB (AOR = 2.821, 95% CI = 1.51–5.29, p < 0.05). Conclusions: Non-suicidal self-injury is associated with ACEs exposure and with those who identify as LGB, and the NSSI odds are greater when students identify as LGB and have experienced ACEs. More interventions to reduce non-suicidal self-injury should focus on LGB and ACEs and more attention needs to be paid to those who identify as LGB and have been exposed to ACEs.
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25
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Motives for Nonsuicidal Self-Injury in Individuals with Lifetime Depressive Disorders and Posttraumatic Stress Disorder. JOURNAL OF PSYCHOPATHOLOGY AND BEHAVIORAL ASSESSMENT 2019. [DOI: 10.1007/s10862-019-09739-w] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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26
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Borschmann R, Stark P, Prakash C, Sawyer SM. Risk profile of young people admitted to hospital for suicidal behaviour in Melbourne, Australia. J Paediatr Child Health 2018; 54:1213-1220. [PMID: 29779227 DOI: 10.1111/jpc.13938] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/09/2017] [Revised: 02/22/2018] [Accepted: 03/19/2018] [Indexed: 11/30/2022]
Abstract
AIM Self-harm and suicidal behaviour is most prevalent during adolescence, but little is known about the risk profile of adolescents admitted to hospital for suicidal behaviour. Young people who self-harm are at an increased risk of mortality compared to those who do not self-harm; adolescents admitted to hospital for suicidal behaviour are particularly at risk. The aim of this study was to generate a risk profile of adolescents admitted to hospital with suicidal behaviour. METHODS We conducted a 12-month retrospective audit of adolescent admissions to the mental health inpatient unit at a tertiary children's hospital in Melbourne, Australia. Routinely collected data were used to generate a risk profile. RESULTS We found that 212 of 271 (78.2%) admissions were due to suicidal behaviour. Of these, 107 (51%) adolescents were diagnosed with one or more mental disorders at discharge, most commonly major depressive disorder. Beyond known distal determinants of health risk, the proximal risk profile of these adolescents included factors relating to gender, substance use, prior mental health diagnoses and prior admission to hospital. Poor sleep was also a risk factor, with 159 (75%) reporting a recent history of sleeping problems. CONCLUSIONS The very high proportion of admissions to the mental health inpatient unit due to suicidal behaviour reinforces the importance of finding effective methods of identification of the risk processes underpinning suicidal behaviours to reduce the unnecessary waste of young lives by suicide.
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Affiliation(s)
- Rohan Borschmann
- Centre for Adolescent Health, Murdoch Children's Research Institute, Melbourne, Victoria, Australia.,Centre for Mental Health, Melbourne School of Population of Global Health, Melbourne, Victoria, Australia.,Department of Psychiatry, University of Melbourne, Melbourne, Victoria, Australia.,Health Service and Population Research Department, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
| | - Patrick Stark
- Mental Health Services, Royal Children's Hospital, Melbourne, Victoria, Australia
| | - Chidambaram Prakash
- Mental Health Services, Royal Children's Hospital, Melbourne, Victoria, Australia
| | - Susan M Sawyer
- Centre for Adolescent Health, Murdoch Children's Research Institute, Melbourne, Victoria, Australia.,Department of Paediatrics, University of Melbourne, Melbourne, Victoria, Australia.,Department of Adolescent Medicine, Royal Children's Hospital, Melbourne, Victoria, Australia
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27
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Baer MM, LaCroix JM, Browne JC, Hassen HO, Perera KU, Weaver J, Soumoff A, Ghahramanlou-Holloway M. Non-Suicidal Self-Injury Elevates Suicide Risk among United States Military Personnel with Lifetime Attempted Suicide. Arch Suicide Res 2018; 22:453-464. [PMID: 28885089 DOI: 10.1080/13811118.2017.1358225] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Military psychiatric inpatients with and without a lifetime history of non-suicidal self-injury (NSSI), combined with a history of at least one suicide attempt, were compared on suicide ideation severity, number of suicide attempts, and Interpersonal-Psychological Theory of Suicide variables. Data were derived from baseline assessments performed in a psychotherapy randomized controlled trial. Lifetime history of NSSI and lifetime number of suicide attempts were assessed using the Columbia Suicide Severity Rating Scale (C-SSRS; Posner et al., 2011 ). Individuals with versus without a combined lifetime history of attempted suicide and NSSI showed significant elevations on thwarted belongingness and acquired capability for suicide. No significant between-group differences were found on perceived burdensomeness, frequency, duration, and controllability of suicide ideation, or number of lifetime suicide attempts. A history of NSSI, above and beyond attempted suicide, appears to increase service members' social alienation and acquired capability for suicide.
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Ougrin D, Corrigall R, Poole J, Zundel T, Sarhane M, Slater V, Stahl D, Reavey P, Byford S, Heslin M, Ivens J, Crommelin M, Abdulla Z, Hayes D, Middleton K, Nnadi B, Taylor E. Comparison of effectiveness and cost-effectiveness of an intensive community supported discharge service versus treatment as usual for adolescents with psychiatric emergencies: a randomised controlled trial. Lancet Psychiatry 2018; 5:477-485. [PMID: 29731412 PMCID: PMC5994473 DOI: 10.1016/s2215-0366(18)30129-9] [Citation(s) in RCA: 58] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/30/2017] [Revised: 03/09/2018] [Accepted: 03/21/2018] [Indexed: 11/30/2022]
Abstract
BACKGROUND Intensive community treatment to reduce dependency on adolescent psychiatric inpatient care is recommended in guidelines but has not been assessed in a randomised controlled trial in the UK. We designed a supported discharge service (SDS) provided by an intensive community treatment team and compared outcomes with usual care. METHODS Eligible patients for this randomised controlled trial were younger than 18 years and had been admitted for psychiatric inpatient care in the South London and Maudsley NHS Foundation Trust. Patients were assigned 1:1 to either the SDS or to usual care by use of a computer-generated pseudorandom code with random permuted blocks of varying sizes. The primary outcome was number of inpatient bed-days, change in Strengths and Difficulties Questionnaire (SDQ) scores, and change in Children's Global Assessment Scale (CGAS) scores at 6 months, assessed by intention to treat. Cost-effectiveness was explored with acceptability curves based on CGAS scores and quality-adjusted life-years (QALYs) calculated from the three-level EuroQol measure of health-related quality of life (EQ-5D-3L), taking a health and social care perspective. This study is registered with the ISRCTN Registry, number ISRCTN82129964. FINDINGS Hospital use at 6 months was significantly lower in the SDS group than in the usual care group (unadjusted median 34 IQR 17-63 vs 50 days, 19-125, p=0·04). The ratio of mean total inpatient days for usual care to SDS was 1·67 (95% CI 1·02-2·81, p=0·04), which decreased to 1·65 (0·99-2·77, p=0·057) when adjusted for differences in hospital use before randomisation. Scores for SDQ and CGAS did not differ between groups. The cost-effectiveness acceptability curve based on QALYs showed that the probability of SDS being cost-effective compared with usual care was around 60% with a willingness-to-pay threshold of £20 000-30 000 per QALY, and that based on CGAS showed at least 58% probability of SDS being cost-effective compared with usual care irrespective of willingness to pay. We recorded no adverse events attributable to SDS or usual care. INTERPRETATION SDS provided by an intensive community treatment team reduced bed usage at 6 months' follow-up but had no effect on functional status and symptoms of mental health disorders compared with usual care. The possibility of preventing admissions, particularly through features such as reduced self-harm and improved reintegration into school, with intensive community treatment should be investigated in future studies. FUNDING South London and Maudsley NHS Trust.
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Affiliation(s)
- Dennis Ougrin
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK; South London and Maudsley NHS Foundation Trust, London, UK.
| | | | - Jason Poole
- South London and Maudsley NHS Foundation Trust, London, UK; Department of Psychology, London South Bank University, London, UK
| | - Toby Zundel
- South London and Maudsley NHS Foundation Trust, London, UK
| | - Mandy Sarhane
- South London and Maudsley NHS Foundation Trust, London, UK
| | | | - Daniel Stahl
- Department of Biostatistics and Health Informatics, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Paula Reavey
- Department of Psychology, London South Bank University, London, UK
| | - Sarah Byford
- Health Service and Population Research Department, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Margaret Heslin
- Health Service and Population Research Department, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - John Ivens
- South London and Maudsley NHS Foundation Trust, London, UK
| | | | - Zahra Abdulla
- Department of Biostatistics and Health Informatics, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Daniel Hayes
- South London and Maudsley NHS Foundation Trust, London, UK
| | | | - Benita Nnadi
- Health Service and Population Research Department, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Eric Taylor
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
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Thomassin K, Quint E, Sezlik S, Shaffer A. Profiles of Emotion Deficits and Adolescent Nonsuicidal Self-Injury in an Inpatient Sample. JOURNAL OF RESEARCH ON ADOLESCENCE : THE OFFICIAL JOURNAL OF THE SOCIETY FOR RESEARCH ON ADOLESCENCE 2017; 27:752-764. [PMID: 29152867 DOI: 10.1111/jora.12312] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
This study examined profiles of specific emotion deficits, including poor emotion awareness, reluctance to express emotion, sadness inhibition and dysregulation, and anger inhibition and dysregulation. Self-report questionnaires assessed adolescents' emotion skills and nonsuicidal self-injury (NSSI) engagement, frequency, severity, methods, and age of onset. Latent profile analysis yielded a three-profile solution: Low Deficit (LD; n = 49), Unaware/Anger Dysregulated (UAD; n = 24), and Anger Inhibited (AI; n = 20) profiles. Adolescents in the UAD profile were more likely to engage in NSSI, displayed a higher NSSI frequency, and reported a higher number of NSSI methods when compared to adolescents in the LD profile. No links emerged for NSSI severity or age of onset.
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30
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Lodebo BT, Möller J, Larsson JO, Engström K. Socioeconomic position and self-harm among adolescents: a population-based cohort study in Stockholm, Sweden. Child Adolesc Psychiatry Ment Health 2017; 11:46. [PMID: 28878818 PMCID: PMC5585967 DOI: 10.1186/s13034-017-0184-1] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/13/2017] [Accepted: 08/23/2017] [Indexed: 12/03/2022] Open
Abstract
BACKGROUND Understanding the association between parental socioeconomic position and self-harm in adolescence is crucial due to its substantial magnitude and associated inequality. Most previous studies have been either of cross-sectional nature or based solely on self-reports or hospital treated self-harm. The aim of this study is to determine the association between parental socioeconomic position and self-harm among adolescents with a specific focus on gender and severity of self-harm. METHODS A total of 165,932 adolescents born 1988-1994 who lived in Stockholm at the age of 13 were followed in registers until they turned 18. Self-harm was defined as first time self-harm and severity of self-harm was defined as hospitalized or not. Socioeconomic position was defined by parental education and household income. Cox proportional hazards regression were used to estimate hazard ratios (HR) with 95% confidence intervals (CI). RESULTS Analyses showed an association between parental socioeconomic position and self-harm. Among adolescents with parents with primary and secondary education compared to tertiary parental education the HR were 1.10 (95% CI 0.97-1.24) and 1.16 (95% CI 1.08-1.25) respectively. Compared to the highest income category, adolescents from the lower income categories were 1.08 (95% CI 0.97-1.22) to 1.19 (95% CI 1.07-1.33) times more likely to self-harm. In gender-stratified analyses, an association was found only among girls. Further, restriction to severe cases eliminated the association. CONCLUSIONS This study suggested that low parental socioeconomic position is associated with self-harm in adolescence, predominantly among girls. The desertion of an association among severe cases may be explained by differences in suicidal intent and underlying psychiatric diagnosis. Efforts to prevent self-harm should consider children with low parental socioeconomic position as a potential target group.
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Affiliation(s)
- Bereket T. Lodebo
- 0000 0004 1937 0626grid.4714.6Department of Public Health Sciences, Karolinska Institutet, Tomtebodavägen 18a, 17177 Stockholm, Sweden
| | - Jette Möller
- 0000 0004 1937 0626grid.4714.6Department of Public Health Sciences, Karolinska Institutet, Tomtebodavägen 18a, 17177 Stockholm, Sweden
| | - Jan-Olov Larsson
- 0000 0004 1937 0626grid.4714.6Department of Women’s and Children’s Health, Karolinska Institutet, 17177 Stockholm, Sweden
| | - Karin Engström
- 0000 0004 1937 0626grid.4714.6Department of Public Health Sciences, Karolinska Institutet, Tomtebodavägen 18a, 17177 Stockholm, Sweden
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31
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Lian Q, Zuo X, Mao Y, Luo S, Zhang S, Tu X, Lou C, Zhou W. Anorexia nervosa, depression and suicidal thoughts among Chinese adolescents: a national school-based cross-sectional study. Environ Health Prev Med 2017; 22:30. [PMID: 29165137 PMCID: PMC5664580 DOI: 10.1186/s12199-017-0639-2] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2016] [Accepted: 01/25/2017] [Indexed: 12/05/2022] Open
Abstract
Background Although there is much literature on adolescent suicide, combined effects of depression and anorexia nervosa on suicide were rarely investigated. The aims of this study are to examine the association between anorexia nervosa and suicidal thoughts and explore the interaction between anorexia nervosa and depression. Methods This is a cross-sectional study, in the study, a sample of 8,746 Chinese adolescents was selected by multistage stratified method in 2012/2013 from 20 middle schools in 7 provinces across China Mainland. Multilevel logistic model was introduced to explore association between anorexia nervosa and suicidal thoughts. And subgroup analyses were conducted on participants with or without depression. Results Multilevel logistic model revealed that demographic variables, including academic achievement, were not the predictive risk factors of suicidal thoughts. Those who suffered from worse severity of perceived anorexia nervosa were at increased risk of thinking about suicide. The interaction between depression and anorexia nervosa was significant, however, subgroup analyses showed that the associations were significant only among the adolescents without depression. Conclusions Our results indicate that all levels of anorexia nervosa serve as predictable indicators of suicidal thoughts in Chinese adolescents, and the effects of anorexia nervosa are modified by depression status.
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Affiliation(s)
- Qiguo Lian
- School of Public Health, Fudan University, Shanghai, China.,Key Lab. of Reproduction Regulation of NPFPC, SIPPR, IRD, Fudan University, 779 Laohumin Road, Shanghai, 200237, China
| | - Xiayun Zuo
- Key Lab. of Reproduction Regulation of NPFPC, SIPPR, IRD, Fudan University, 779 Laohumin Road, Shanghai, 200237, China
| | - Yanyan Mao
- School of Public Health, Fudan University, Shanghai, China.,Key Lab. of Reproduction Regulation of NPFPC, SIPPR, IRD, Fudan University, 779 Laohumin Road, Shanghai, 200237, China
| | - Shan Luo
- West China Second University Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Shucheng Zhang
- National Research Institute for Family Planning, Beijing, China
| | - Xiaowen Tu
- Key Lab. of Reproduction Regulation of NPFPC, SIPPR, IRD, Fudan University, 779 Laohumin Road, Shanghai, 200237, China
| | - Chaohua Lou
- Key Lab. of Reproduction Regulation of NPFPC, SIPPR, IRD, Fudan University, 779 Laohumin Road, Shanghai, 200237, China.
| | - Weijin Zhou
- Key Lab. of Reproduction Regulation of NPFPC, SIPPR, IRD, Fudan University, 779 Laohumin Road, Shanghai, 200237, China
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Functions of nonsuicidal self-injury (NSSI): Cross-sectional associations with NSSI duration and longitudinal changes over time and following treatment. Psychiatry Res 2016; 241:83-90. [PMID: 27156029 DOI: 10.1016/j.psychres.2016.04.083] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/17/2015] [Revised: 04/21/2016] [Accepted: 04/22/2016] [Indexed: 11/24/2022]
Abstract
In this study, we sought to clarify if and how the functions of nonsuicidal self-injury (NSSI) relate to duration of NSSI or change over time. To accomplish this aim, we analyzed data obtained from routine clinical evaluations completed within a specialized acute-care treatment program for NSSI. Specifically, we examined how functions of NSSI vary between patients by duration of NSSI, how functions changed within patients over time, and how changes in NSSI functions related to treatment outcomes. Neither internal nor social functions were associated with NSSI duration between patients after controlling for relevant covariates. For patients completing two admissions assessments, internal and social functions decreased similarly over time, although the decrease in internal functions was no longer significant after controlling for decreases in NSSI urges. For patients who completed admissions and discharge assessments, internal and social functions decreased over the course of treatment, with larger decreases in internal functions. Decreases in both types of functions related to improved treatment outcomes. In conclusion, our results suggest that NSSI functions are generally stable across time, although decreases in NSSI functions may relate to clinical improvement.
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33
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Mallard TT, Doorley J, Esposito-Smythers CL, McGeary JE. Dopamine D4 receptor VNTR polymorphism associated with greater risk for substance abuse among adolescents with disruptive behavior disorders: Preliminary results. Am J Addict 2015; 25:56-61. [DOI: 10.1111/ajad.12320] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2015] [Revised: 11/10/2015] [Accepted: 12/02/2015] [Indexed: 11/28/2022] Open
Affiliation(s)
- Travis T. Mallard
- Department of Psychology; University of Texas at Austin; Austin Texas
- Department of Psychology; George Mason University; Fairfax Virginia
| | - James Doorley
- Department of Psychology; George Mason University; Fairfax Virginia
| | | | - John E. McGeary
- Providence VA Medical Center; Brown University Medical School; Providence Rhode Island
- Alpert Medical School of Brown University; Brown University Medical School; Providence Rhode Island
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Few LR, Werner KB, Sartor CE, Grant JD, Trull TJ, Nock MK, Bucholz KK, Deitz SK, Glowinski AL, Martin NG, Nelson EC, Statham DJ, Madden PAF, Heath AC, Lynskey MT, Agrawal A. Early onset alcohol use and self-harm: a discordant twin analysis. Alcohol Clin Exp Res 2015; 39:2134-42. [PMID: 26463647 DOI: 10.1111/acer.12889] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2015] [Accepted: 08/26/2015] [Indexed: 01/05/2023]
Abstract
BACKGROUND Self-harm has considerable societal and economic costs and has been extensively studied in relation to alcohol involvement. Although early onset alcohol use (EAU) has been causally linked to maladaptive clinical outcomes, its association with self-harm is less well characterized. This study aimed to further examine the link between EAU and both nonsuicidal self-injury (NSSI) and suicide attempt (SA), and elucidate shared familial and causal/individual-specific pathways that explain this co-occurrence. METHODS Using data from 6,082 Australian same-sex twin pairs (1,732 monozygotic [MZ] and 1,309 dizygotic [DZ]), ages 23 to 40, we examined prevalence rates of NSSI and SA among twin pairs concordant and discordant for EAU. Conditional logistic regression, controlling for early clinical covariates and the influence of zygosity on EAU, was used to examine the odds ratio (OR) of self-harm within twin pairs discordant for EAU. RESULTS Prevalence rates of both NSSI and SA were highest among twin pairs concordant for EAU and for twins who reported EAU within discordant twin pairs. Results from discordant twin analyses revealed nearly 4-fold increased odds of SA for the twin who endorsed EAU, and this OR was equal across MZ and DZ twins. EAU also was associated with elevated odds of NSSI (OR = 7.62), although this was only the case for DZ twins in discordant pairs. CONCLUSIONS The equivalent increase in odds of SA for both MZ and DZ twins suggests that causal or individual-specific influences explain the link between EAU and SA. For NSSI, elevated odds for DZ twins and nonsignificant findings for MZ twins implicate correlated genetic factors in the association between EAU and NSSI. Future studies should test mechanisms through which EAU may causally influence SA, as well as examine whether genetic risk for third variables (e.g., negative urgency, stress reactivity) may explain the genetic overlap between EAU and NSSI.
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Affiliation(s)
- Lauren R Few
- Department of Psychiatry, Washington University School of Medicine, Saint Louis, Missouri
| | - Kimberly B Werner
- George Warren Brown School of Social Work, Washington University, Saint Louis, Missouri
| | - Carolyn E Sartor
- Department of Psychiatry, Washington University School of Medicine, Saint Louis, Missouri.,Department of Psychiatry, Yale University School of Medicine, West Haven, Connecticut
| | - Julia D Grant
- Department of Psychiatry, Washington University School of Medicine, Saint Louis, Missouri
| | - Timothy J Trull
- Department of Psychological Sciences, University of Missouri, Columbia, Missouri
| | - Matthew K Nock
- Department of Psychology, Harvard University, Cambridge, Massachusetts
| | - Kathleen K Bucholz
- Department of Psychiatry, Washington University School of Medicine, Saint Louis, Missouri
| | - Sarah K Deitz
- Department of Psychiatry, Washington University School of Medicine, Saint Louis, Missouri
| | - Anne L Glowinski
- Department of Psychiatry, Washington University School of Medicine, Saint Louis, Missouri
| | | | - Elliot C Nelson
- Department of Psychiatry, Washington University School of Medicine, Saint Louis, Missouri
| | - Dixie J Statham
- School of Social Sciences, University of the Sunshine Coast, Sippy Downs, Queensland, Australia
| | - Pamela A F Madden
- Department of Psychiatry, Washington University School of Medicine, Saint Louis, Missouri
| | - Andrew C Heath
- Department of Psychiatry, Washington University School of Medicine, Saint Louis, Missouri
| | - Michael T Lynskey
- Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, United Kingdom
| | - Arpana Agrawal
- Department of Psychiatry, Washington University School of Medicine, Saint Louis, Missouri
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The association of non-suicidal self-injury and suicidal behavior according to DSM-5 in adolescent psychiatric inpatients. Psychiatry Res 2015; 228:454-61. [PMID: 26144578 DOI: 10.1016/j.psychres.2015.06.019] [Citation(s) in RCA: 59] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/06/2014] [Revised: 06/21/2015] [Accepted: 06/25/2015] [Indexed: 11/23/2022]
Abstract
Non-suicidal self-injury (NSSI) and suicidal behaviors frequently occur among adolescent psychiatric patients. Although those behaviors are distinct with regards to intent, NSSI has been shown to be an important risk-factor for suicide attempts. However, the association of NSSI and Suicidal Behavior Disorder (SBD) according to DSM-5 criteria has not yet been investigated. For investigating distinctive features and mutual risk-factors of NSSI-disorder and SBD, adolescent psychiatric inpatients (N=111, aged 12-19 years; 65.8% females) were interviewed using the Self-Injurious-Thoughts-And-Behaviors-Interview-German (SITBI-G). NSSI started significantly earlier in life (M=12.5 years, SD=2.2) than first suicide attempts (M=14.1 years, SD=2.0). Patients meeting NSSI-disorder and/or SBD were significantly more likely to be female and to be diagnosed with an affective disorder. NSSI-disorder and SBD seem to have several distinctive features (i.e. age of onset or frequency), but also seem to share certain mutual risk-factors (i.e. affective disorders, female gender). While both NSSI and SBD seem to be maintained by mainly automatic negative reinforcement, positive automatic and social functions were rated significantly higher for NSSI. Most importantly, NSSI seems to be a strong risk factor for the occurrence of SBD (even when controlling for suicidal ideation) and should therefore always be assessed when dealing with psychiatric adolescent patients.
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Choon MW, Abu Talib M, Yaacob SN, Awang H, Tan JP, Hassan S, Ismail Z. Negative automatic thoughts as a mediator of the relationship between depression and suicidal behaviour in an at-risk sample of Malaysian adolescents. Child Adolesc Ment Health 2015; 20:89-93. [PMID: 32680393 DOI: 10.1111/camh.12075] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/05/2014] [Indexed: 11/28/2022]
Abstract
BACKGROUND This study examined the mediating role of negative automatic thoughts in the relationship between depression and suicidal behaviour in a sample of at-risk Malaysian adolescents. METHOD A total of 1441 adolescents were initially recruited via multistage cluster sampling. Subsequently, 294 at-risk adolescents were selected for further analyses through a specified cut-off score. RESULTS The results showed significant positive relationships among the study variables. Specifically, negative automatic thoughts emerged as a significant mediator in the relation between depression and suicidal behaviour (z = 7.15, p < .001). CONCLUSIONS The findings suggest that depressed adolescents are at high risk for a host of negative thought processes which in turn lead to suicidal behaviour. The study limitations and recommendations for further research are discussed.
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Affiliation(s)
- Min Wai Choon
- Department of Human Development and Family Studies, Universiti Putra Malaysia, Serdang, Malaysia
| | - Mansor Abu Talib
- Department of Human Development and Family Studies, Universiti Putra Malaysia, Serdang, Malaysia
| | - Siti Nor Yaacob
- Department of Human Development and Family Studies, Universiti Putra Malaysia, Serdang, Malaysia
| | - Hamidin Awang
- Department of Psychiatry, Universiti Putra Malaysia, Serdang, Malaysia
| | - Jo Pei Tan
- Department of Social Work and Social Care, Faculty of Health, Psychology and Social Care, Manchester Metropolitan University, United Kingdom
| | - Sallahuddin Hassan
- Department of Economics and Agribusiness, Universiti Utara Malaysia, Sintok, Malaysia
| | - Zanariah Ismail
- Department of Human Development and Family Studies, Universiti Putra Malaysia, Serdang, Malaysia
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Kara K, Ozsoy S, Teke H, Congologlu MA, Turker T, Renklidag T, Karapirli M. Non-suicidal self-injurious behavior in forensic child and adolescent populations. Clinical features and relationship with depression. NEUROSCIENCES (RIYADH, SAUDI ARABIA) 2015; 20:31-6. [PMID: 25630778 PMCID: PMC4727602] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECTIVE To investigate risk factors for non-suicidal self-injury (NSSI), and present the relationship between NSSI and depression in children and adolescents who appeared for forensic examination. METHODS This study consisted of 295 children and adolescents who were brought for judicial examination in the TR Ministry of Justice Forensic Science Department, Council of Forensic Medicine, Ankara, Turkey between May and October 2013. Sociodemographic factors, alcohol and substance abuse, and history of sexual abuse and suicide attempts were assessed using a semi-structured questionnaire. During forensic medical examinations, NSSI was evaluated. Depression was assessed using the Beck Depression Inventory. RESULTS The frequency of NSSI was 20.2% among boys, and 30.6% among girls. Statistical differences were found between subjects with and without NSSI in terms of number of children in their families, whether or not their parents were divorced, whether they held part-time jobs, or had a history of sexual abuse, substance abuse, or suicide attempts, and the number of criminal involvements. Those with NSSI had higher depressive scores than others (p<0.001). CONCLUSION Children and adolescents with NSSI have wide-ranging problems in their lives. In a forensic adolescent population, depressive symptoms are more common in individuals with NSSI behaviors, and the specific characteristics of these behaviors need further investigation.
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Affiliation(s)
- Koray Kara
- From the Child and Adolescent Psychiatry Department (Kara, Congologlu), the Forensic Medicine Department (Ozsoy) and the Public Health Department (Turker), Gulhane Military Medical Academy, and the TR Ministry of Justice Forensic Science Department (Teke, Renklidag, Karapirli), Council of Forensic Medicine, Ankara Group Chairmanship, Ankara, Turkey,Address correspondence and reprint request to: Dr. Koray Kara, Department of Child and Adolescent Psychiatry, Gulhane Military Medical Academy, Etlik Kecioren, Ankara, Turkey. E-mail:
| | - Sait Ozsoy
- From the Child and Adolescent Psychiatry Department (Kara, Congologlu), the Forensic Medicine Department (Ozsoy) and the Public Health Department (Turker), Gulhane Military Medical Academy, and the TR Ministry of Justice Forensic Science Department (Teke, Renklidag, Karapirli), Council of Forensic Medicine, Ankara Group Chairmanship, Ankara, Turkey
| | - Hacer Teke
- From the Child and Adolescent Psychiatry Department (Kara, Congologlu), the Forensic Medicine Department (Ozsoy) and the Public Health Department (Turker), Gulhane Military Medical Academy, and the TR Ministry of Justice Forensic Science Department (Teke, Renklidag, Karapirli), Council of Forensic Medicine, Ankara Group Chairmanship, Ankara, Turkey
| | - M. Ayhan Congologlu
- From the Child and Adolescent Psychiatry Department (Kara, Congologlu), the Forensic Medicine Department (Ozsoy) and the Public Health Department (Turker), Gulhane Military Medical Academy, and the TR Ministry of Justice Forensic Science Department (Teke, Renklidag, Karapirli), Council of Forensic Medicine, Ankara Group Chairmanship, Ankara, Turkey
| | - Turker Turker
- From the Child and Adolescent Psychiatry Department (Kara, Congologlu), the Forensic Medicine Department (Ozsoy) and the Public Health Department (Turker), Gulhane Military Medical Academy, and the TR Ministry of Justice Forensic Science Department (Teke, Renklidag, Karapirli), Council of Forensic Medicine, Ankara Group Chairmanship, Ankara, Turkey
| | - Tulay Renklidag
- From the Child and Adolescent Psychiatry Department (Kara, Congologlu), the Forensic Medicine Department (Ozsoy) and the Public Health Department (Turker), Gulhane Military Medical Academy, and the TR Ministry of Justice Forensic Science Department (Teke, Renklidag, Karapirli), Council of Forensic Medicine, Ankara Group Chairmanship, Ankara, Turkey
| | - Mustafa Karapirli
- From the Child and Adolescent Psychiatry Department (Kara, Congologlu), the Forensic Medicine Department (Ozsoy) and the Public Health Department (Turker), Gulhane Military Medical Academy, and the TR Ministry of Justice Forensic Science Department (Teke, Renklidag, Karapirli), Council of Forensic Medicine, Ankara Group Chairmanship, Ankara, Turkey
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Preyde M, Vanderkooy J, Chevalier P, Heintzman J, Warne A, Barrick K. The Psychosocial Characteristics Associated with NSSI and Suicide Attempt of Youth Admitted to an In-patient Psychiatric Unit. JOURNAL OF THE CANADIAN ACADEMY OF CHILD AND ADOLESCENT PSYCHIATRY = JOURNAL DE L'ACADEMIE CANADIENNE DE PSYCHIATRIE DE L'ENFANT ET DE L'ADOLESCENT 2014; 23:100-10. [PMID: 24872825 PMCID: PMC4032078] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 09/18/2013] [Accepted: 01/10/2014] [Indexed: 06/03/2023]
Abstract
INTRODUCTION The purpose of this study was to explore the prevalence of self-harm and the psychosocial factors associated with self-harming behaviours in youth admitted to an in-patient psychiatric unit. METHODS Cross-sectional surveys of standardized measures were administered to youth and a separate survey to their caregivers while the youth were in hospital. RESULTS The mean age of the 123 youth who participated was 15.74 (SD 1.51) years, and 90 of 121 (74.38%) reported being female. Of the 115 who completed this question, 101 (87.83%) indicated that they thought of injuring themselves and 89 (77.39%) did engage in NSSI within the past month, and 78 of 116 (67%) reported that they had made an attempt to take their life. Youth who reported that they had attempted suicide (lifetime) reported significantly less difficulty with emotion regulation than youth who engaged in NSSI only, or both NSSI and suicide attempts. CONCLUSIONS These youth reported a very high prevalence of self-harm, and in general substantial difficulty with regulating their emotions, and difficulty with their interpersonal relationships. The psychosocial distinctions evident between groups may have practical utility.
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Affiliation(s)
- Michèle Preyde
- College of Social and Applied Human Sciences, University of Guelph, Guelph, Ontario
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Wolff J, Esposito-Smythers C, Becker S, Seaboyer L, Rizzo C, Lichtenstein D, Spirito A. Social-Cognitive Moderators of the Relationship between Peer Victimization and Suicidal Ideation among Psychiatrically Hospitalized Adolescents. JOURNAL OF AGGRESSION, MALTREATMENT & TRAUMA 2014; 23:268-285. [PMID: 25125940 PMCID: PMC4130392 DOI: 10.1080/10926771.2014.883458] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
Peer victimization among children and adolescents is a major public health concern, given its widespread individual and societal ramifications. Victims of peer aggression often face significant levels of psychological distress and social difficulties, such as depression, suicidal ideation, suicide attempts, and social rejection. The purpose of the present study was to examine whether cognitive distortions and perceptions of social support moderate the association between peer victimization and suicidal thoughts among psychiatrically hospitalized adolescents. Participants included 183 psychiatrically hospitalized adolescents (ages 13-18). In multiple regression analyses that controlled for gender, social and cognitive factors served as significant resources factors. Cognitive factors also moderated the relationship between peer victimization and suicidal ideation.
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Affiliation(s)
- Jennifer Wolff
- Warren Alpert Medical School of Brown University ; Rhode Island Hospital
| | | | - Sara Becker
- Warren Alpert Medical School of Brown University ; Rhode Island Hospital
| | | | - Christie Rizzo
- Warren Alpert Medical School of Brown University ; Rhode Island Hospital
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