A Comparison between Severe Suicidality and Nonsuicidal Self-Injury Behaviors in Bipolar Adolescents Referred to a Psychiatric Emergency Unit

Abstract

Background: Severe suicide ideation or attempts and non-suicidal self-injury (NSSI) present both differences and relevant overlaps, including frequent co-occurrence and shared risk factors. Specific categorical diagnoses, namely bipolar disorder (BD), may affect clinical features and natural histories of suicidal or not suicidal self-harm behaviour. Our study aimed to compare suicidality (severe suicidal ideation or suicidal attempts) and NSSI in referred bipolar adolescents. Methods: The sample included 95 bipolar adolescents (32 males, 63 females) aged 11 to 18 years. Thirty adolescents with suicide attempts/suicidal ideation and BD (SASIB) were compared with structured measures to 35 adolescents with NSSI and BD, without suicidal ideation or attempts (NSSIB), and to 30 adolescents with BD, without suicidal ideation or attempts or NSSI (CB). Results: Compared to CB, suicidality and NSSI were both associated with female sex, borderline personality disorder and self-reported internalizing disorders, anxiety/depression and thought disorders. The NSSI were specifically associated with somatic problems. Severe suicidal ideation and suicide attempts were associated with adverse life events, immigration, bullying, eating disorders, social problems, depressive feelings, performance and social anxiety, and feelings of rejection. Conclusions: Both shared and differential features between suicidal and not suicidal adolescents may represent possible targets for diagnostic and preventative interventions.

How COVID-19 Phases Have Impacted Psychiatric Risk: A Retrospective Study in an Emergency Care Unit for Adolescents

“…To deepen possible elements associated with an increased risk of sever suicide ideation and attempts, internalizing disorder and adverse childhood experiences emerged as significant risk factors, consistent with the literature data and our previous findings [10,39,40]. Regarding age and gender differences, our findings are consistent with prior studies, which showed that suicide attempts are more common in adolescent females.…”

The relationship between negative life events and non-suicidal self-injury (NSSI) among Chinese junior high school students: the mediating role of emotions

“…The reason why the results of this study were higher than those of previous studies may be due to the differences in the criteria for defining and measuring NSSI. For example, in Tang et al's study, the criterion for self-injury was defined as “occurring more than 5 times per year”, whereas in Martin et al's study, the instrument used to measure NSSI was a question that asked, “During the past 12 months, how many times did you do something to purposely hurt yourself without wanting to die, such as cutting or burning yourself on purpose?” The prevalence of NSSI is higher in girls than in boys, which is the same as previous studies [ 50 , 51 ]. Previous research has shown [ 52 ] that men are more likely to take direct action, i.e., action to change the problem, in response to life events than women, so that when faced with negative life events, boys are more likely to take action to solve the problem, whereas girls may need more time to deal with these negative life events.…”

Tumor markers and depression scores are predictive of non-suicidal self-injury behaviors among adolescents with depressive disorder: A retrospective study

“…According to this theory, the occurrence of NSSI is not intended for suicide purposes; however, NSSI is closely related to SI, AS, and SB ( Hawton et al, 2003 ; Nock et al, 2008 ; Martin et al, 2010 ), where NSSI frequency, number of self-injury methods, and hopelessness are the strongest predictors of AS ( Victor and Klonsky, 2014 ; Coppersmith et al, 2017 ). Notably, NSSI is a risk factor for committing suicide among adolescents with depression ( Hawton et al, 2003 ; Zubrick et al, 2017 ; Fan et al, 2021 ; Masi et al, 2021 ). In particular, female adolescents have a higher risk of committing suicide if they exhibit frequent NSSI behaviors ( You and Lin, 2015 ).…”