Self-injury prevalence in adolescents: A global systematic review and meta-analysis

Lucena, Natasha Lemos; Rossi, Thaís Régis Aranha; Azevêdo, Laylla Mirella Galvão; Pereira, Marcos

doi:10.1016/j.childyouth.2022.106634

Cited by 13 publications

(9 citation statements)

References 32 publications

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“…Following this pathway, it seems that our reporting is quite in accord with the literature concerning the prevalence of major mental disorders, including anxiety, 21,22 depression, 23,24 bipolar disorder, [25][26][27][28] and psychosis, 29,30 as well as self-injury. [31][32][33] While the history of suicidal attempts was found to pass 10%, the rates reported in the literature vary between 2% and 5%, [34][35][36][37][38][39][40] however, the variability is great and it seems that selective retrieval of memories is involved. This is evident since studies in adolescents report rates around 20%, 41,42 while surveys in middle-aged individuals report much lower lifetime rates.…”

Section: Discussionmentioning

confidence: 99%

Somatic multicomorbidity and disability in patients with psychiatric disorders in comparison to the general population: a quasi-epidemiological investigation in 54,826 subjects from 40 countries (COMET-G study)

Fountoulakis,

Karakatsoulis,

Abraham

et al. 2024

CNS Spectr.

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Background The prevalence of medical illnesses is high among patients with psychiatric disorders. The current study aimed to investigate multi-comorbidity in patients with psychiatric disorders in comparison to the general population. Secondary aims were to investigate factors associated with metabolic syndrome and treatment appropriateness of mental disorders. Methods The sample included 54,826 subjects (64.73% females; 34.15% males; 1.11% nonbinary gender) from 40 countries (COMET-G study). The analysis was based on the registration of previous history that could serve as a fair approximation for the lifetime prevalence of various medical conditions. Results About 24.5% reported a history of somatic and 26.14% of mental disorders. Mental disorders were by far the most prevalent group of medical conditions. Comorbidity of any somatic with any mental disorder was reported by 8.21%. One-third to almost two-thirds of somatic patients were also suffering from a mental disorder depending on the severity and multicomorbidity. Bipolar and psychotic patients and to a lesser extent depressives, manifested an earlier (15–20 years) manifestation of somatic multicomorbidity, severe disability, and probably earlier death. The overwhelming majority of patients with mental disorders were not receiving treatment or were being treated in a way that was not recommended. Antipsychotics and antidepressants were not related to the development of metabolic syndrome. Conclusions The finding that one-third to almost two-thirds of somatic patients also suffered from a mental disorder strongly suggests that psychiatry is the field with the most trans-specialty and interdisciplinary value and application points to the importance of teaching psychiatry and mental health in medical schools and also to the need for more technocratically oriented training of psychiatric residents.

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Section: Discussionmentioning

confidence: 99%

Somatic multicomorbidity and disability in patients with psychiatric disorders in comparison to the general population: a quasi-epidemiological investigation in 54,826 subjects from 40 countries (COMET-G study)

Fountoulakis,

Karakatsoulis,

Abraham

et al. 2024

CNS Spectr.

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“…Deliberate self-injury (SI) appears as a symptom of various psychiatric disorders. The global prevalence of self-injurious behavior is around 19% among adolescents and young adults, peaking in European countries and more frequently affecting females [ 1 ]. Self-induced bloodletting (‘Self-bloodletting’ or SBL) represents a rare expression of self-harm with possible suicidal intentions, wherein patients drain their own blood via venipuncture or other forms of vessel injuries [ 2 ].…”

Section: Introductionmentioning

confidence: 99%

Successful Pharmacologic Treatment of Self-Bloodletting with Factitious Chronic Anemia (Lasthénie de Ferjol Syndrome) with High-Dose Serotonergic Medication: A Case Report

Mestermann,

Rudtke,

Brazdis

et al. 2024

Behavioral Sciences

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Self-induced bloodletting (SBL) is a very rare form of self-injury (SI) seen primarily in adolescents and young adults with personality and eating disorders. It can result in complications like malaise, fatigue, or iron-deficiency anemia (Lasthénie de Ferjol syndrome, LFS), and poses a risk of accidental death or suicide. The condition often goes undetected due to patient concealment. There is no specific treatment established, and pharmacological strategies remain uncertain. We discuss the case of a 22-year-old female patient treated at our Psychiatry and Psychotherapy Department following a suicide attempt via SBL. She self-administered a venous cannula, losing 1.5 L of blood. Diagnosed with iron-deficiency anemia (LFS), she was initially treated with mirtazapine, risperidone, lithium, and later off-label high-dose clomipramine (300 mg/d). Clomipramine significantly reduced her SBL and suicidal thoughts, and her hemoglobin levels re-normalized under iron-substitution therapy. Despite improvement and later discharge, she attempted suicide by SBL again three months later, having stopped clomipramine due to adverse side effects. High-dose escitalopram was administered, leading to a decrease and eventual cessation of her SBL urges. This case demonstrates that patients with SBL/LFS can benefit from high-dose clomipramine or escitalopram. Despite its rarity, the consideration of high-dose serotonergic antidepressants is crucial in psychiatric diagnostics and treatment for patients affected by SBL/LFS.

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“…Considerable heterogeneity in rates has been found, however [14]. A 2014 meta-analysis found NSSI prevalence was 17.2% among adolescents, 13.4% among young adults (typically defined as between the ages of 18 and 25 years), and 5.5% among adults [14], while a 2022 international systematic review found lifetime prevalence rates of 21% among adolescents [15]. Meanwhile, almost half of the first-year university student participants in a 2015 study reported that they had, at some point in their life, engaged in NSSI [2].…”

Section: Introductionmentioning

confidence: 99%

“…These two studies used assessments that included a wide range of methods of NSSI, as well as the option of adding a free-text answer; this may account for the relatively high reported prevalence. It is also possible that the second study [15] overestimates prevalence as a convenience (self-selected) sample was used. The use of differing definitions, assessment items, and sampling methods is a known issue in the research on NSSI e.g., [14].…”

Section: Introductionmentioning

confidence: 99%

The Effect of Gender on Identification and Interpretation of Non-Suicidal Self-Injury

Curtis,

Terry

2023

Psychopathology

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Introduction: Reported rates of non-suicidal self-injury (NSSI) differ by gender but may be under-reported and under-recognised in men. People engaging in NSSI rarely seek professional help without encouragement, so others play a key role in its identification and potential intervention. The current research investigated others’ interpretations of NSSI, examining whether gender affects the likelihood of NSSI identification and views of how common and acceptable NSSI is. Method: Participants (N = 429; 74.1% female, 23.3% male; please see below for further demographic information) responded to two vignettes describing a person self-injuring by punching a wall or by cutting themselves. The person’s gender in each vignette was manipulated. Following each vignette, the participants rated the level to which they agreed the behaviour was common for the gender of the person described, as well as the level to which they agreed the behaviour was acceptable for the gender of the person described, on a 5-point Likert scale. Following both vignettes, participants were presented with a definition of NSSI and rated the level to which they agreed cutting and wall-punching were forms of NSSI on 5-point Likert scales. Independent-samples t tests and goodness of fit χ2 tests were conducted as appropriate. Results: Participants were more likely to identify wall-punching as common for men and cutting as common for women. However, there was no significant difference in whether wall-punching was identified as NSSI or considered to be an acceptable behaviour, regardless of the gender of the person engaging in it. That is, although research suggests that men are far more likely to engage in wall-punching as a form of NSSI than women, participants did not recognise this. Overall, the results indicated a gender-dependent difference in how acceptable and common NSSI is thought to be, but no noticeable difference in identification of a behaviour as NSSI. Wall-punching, typically a form of NSSI engaged in by males, tended not to be identified as such. Conclusion: There is an effect of gender on how NSSI is interpreted, and it seems that men’s NSSI is, and will continue to be, under-recognised. This has important implications for the treatment of men’s NSSI, which is more likely to be seen as aggression and therefore deserving of punishment than an attempt at emotion regulation.

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Self-injury prevalence in adolescents: A global systematic review and meta-analysis

Cited by 13 publications

References 32 publications

Somatic multicomorbidity and disability in patients with psychiatric disorders in comparison to the general population: a quasi-epidemiological investigation in 54,826 subjects from 40 countries (COMET-G study)

Somatic multicomorbidity and disability in patients with psychiatric disorders in comparison to the general population: a quasi-epidemiological investigation in 54,826 subjects from 40 countries (COMET-G study)

Successful Pharmacologic Treatment of Self-Bloodletting with Factitious Chronic Anemia (Lasthénie de Ferjol Syndrome) with High-Dose Serotonergic Medication: A Case Report

The Effect of Gender on Identification and Interpretation of Non-Suicidal Self-Injury

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