Assessment of the association between non-suicidal self-injury disorder and suicidal behaviour disorder in females with conduct disorder

Abstract

Background Non-suicidal self-injury (NSSI) and aggression have been demonstrated to serve as risk factors of suicidal behaviours (SB). Non-suicidal self-injury disorder (NSSID) and Suicidal Behaviour Disorder (SBD) are among new diagnostic categories for further studies in the DSM-5 classification. Methods We recruited 196 girls (aged 15.5 ± 1.2 years) diagnosed with conduct disorder (CD). All of them were assessed with respect of non-suicidal self-injury acts, suicidal attempts, psychopathology, self-esteem and general functioning. Results Age of NSSI onset was significantly lower compared to age of first suicidal attempt. SBD was present in 50.0% of patients with NSSID and the prevalence of NSSID in individuals with SBD was estimated at 52.2%. A diagnosis of NSSID, with at least 8 days of engagement in self-injuries during the preceding year, significantly predicted the risk of SBD. This effect appeared to be independent of depressive symptomatology. Limitations Our results cannot be generalized over the whole population of individuals diagnosed with CD because of a lack of male patients, as well as individuals with the most severe and mildest forms of CD. Causal inferences cannot be established due to a cross-sectional study design. Conclusions The NSSID with at least 8 days of engagement in self-injuries during the preceding year serves as a predictor of SBD independently of the effects of depressive symptoms. Longitudinal studies are required to confirm our findings.

DSM-5 suicidal behavior disorder: a systematic review of research on clinical utility, diagnostic boundaries, measures, pathophysiology and interventions

“…Groschwitz and colleagues ( 16 ) investigated the association between NSSID and SBD in 111 adolescent psychiatric inpatients and found that the two tend to co-occur, with NSSID acting as a strong risk factor for the occurrence of SBD. Similar results were found by Szewczuk-Bogusławska and colleagues ( 17 ). There was high co-occurrence of SBD and NSSID in their sample of 196 adolescent girls with conduct disorder, and a diagnosis of NSSID, with a minimum of eight days of self-injury engagement within the last 12 months, significantly predicted the risk of SBD.…”

Self-Injuries and Their Functions with Respect to Suicide Risk in Adolescents with Conduct Disorder: Findings from a Path Analysis

“…This study is a continuation of our previous project on a female sample, whose results were published elsewhere [ 5 ]. The studied group was extended to enlarge the sample and to include male participants.…”

“…Non-suicidal self-injuries (NSSIs) have been identified as one of the strongest risk factors of suicidal behaviours in adolescents according to previous studies [ 1 , 2 ]. Younger age at onset of NSSIs, in comparison with suicide attempts, has been replicated by studies conducted in the general population and in patients diagnosed with mental disorders, indicating that NSSIs precede suicidal behaviours [ 3 , 4 , 5 ]. Taking into account significantly higher prevalence of NSSIs in comparison with suicidal attempts estimated in the general population of adolescents (17.0–18.0% vs. 4.1–6.7%), different characteristics of NSSIs and other variables that might potentially affect the link between NSSIs and suicide attempts are extensively being investigated [ 6 , 7 ].…”

“…High co-occurrence of NSSID and SBD was found in a suicide sample of psychiatric inpatients, where even 51.2% patients with NSSID might meet the SBD criteria, and 65.6% individuals diagnosed with SBD meet the NSSID criteria [ 15 ]. Our recent study of adolescent girls diagnosed with conduct disorder (CD) estimated the prevalence of SBD at 50.0% in individuals with NSSID, and NSSID was present in 52.2% patients with SBD [ 5 ].…”