Gender and Age Influence on Emergency Department Visits for Non-Suicidal Self-Injuries in School Aged Children in Italy: An 11 Years Retrospective Cross-Sectional Study (original) (raw)
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The Emergency Assessment and Management of Non-Suicidal Self-Injury in Adolescents
Adolescent Psychiatry, 2019
DOI: 10.2174/2210676609666190618162558 Abstract: Background and Goals: Non-suicidal self-injury (NSSI) is a common presenting issue mental health providers experience in all levels of care from outpatient clinics to inpatient units. It is common among adolescents seen in emergency settings, either as a presenting problem or as a covert condition that may not be detected unless specifically assessed for. The presence of NSSI increases the risk of suicide. This article aims to help the clinician develop a better understanding of NSSI – what it may entail, the prevalence, and the motivations for why young people engage in it.
Nonsuicidal Self-Injury: A Neglected Public Health Problem Among Adolescents
American Journal of Public Health, 2018
In this issue of AJPH, Monto et al. (p. XXX) take an important step in providing prevalence estimates and health risk behavior correlates of nonsuicidal self-injury (NSSI) among a large nonclinical sample of high school students in 11 states using 2015 Youth Risk Behavior Surveillance System (YRBSS) data. They found that17.6% of adolescents had engaged in at least one form of NSSI within the past year, including just over one in 10 male adolescents and nearly one in four female adolescents. This work adds to the current body of epidemiological research on NSSI and demonstrates a substantial population-level burden of NSSI among youths. It also builds on research from the 2007 Minnesota Student Survey, a population-based survey of Minnesota high school students that found an NSSI prevalence of 7.3% among youths who had never experienced suicidality. 1 The 2016 Minnesota Student Survey employed an NSSI question similar to that of the YRBSS and showed rates (15%-16%) comparable to those observed by Monto et al. DISENTANGLING NSSI AND SUICIDALITY Monto et al. found strong associations between NSSI and past-year suicide attempts, consistent with previous research demonstrating that adolescents who engage in NSSI are at an increased risk of subsequently attempting suicide. In fact, several studies suggest that specifically among adolescents who are depressed, a history of NSSI may be a stronger risk factor for attempting suicide than is a past suicide attempt. 2 NSSI poses a particular challenge for youth-serving clinicians and mental health systems. Youths are often evaluated in emergency departments for NSSI, and many are admitted unnecessarily to psychiatric inpatient programs. Because the behavior is, by definition, not suicidal in intent, many youths may be best served with community-based mental health
Child Indicators Research, 2019
To analyse sex differences and associations regarding non-suicidal self-injury (NSSI) behaviour and their relationship with other health compromising behaviours. Were inquired 3262 Portuguese adolescents as participants in the context of the Health Behaviour in School-aged Children study/WHO. 20.3% of the adolescents reported at least one NSSI episode. Students from 8th grade had more NSSI than 10th grade students. Concerning sex, girls report more NSSI than boys. The occurrence of NSSI for both sexs is related to alcohol use, being bullied, being a bully, carrying weapons, and safety perception at school. Regarding boys, NSSI is also related to physical activity (PA), drugs use and school grade. For both sexs, being bullied, being a bully and carrying weapons had a positive association with the NSSI occurrence. For girls, also alcohol use had a positive association with the NSSI occurrence. Safety perception at school was negatively associated with the NSSI occurrence in girls. Regarding the 8th and 10th grade students' being bullied and carrying weapons had a positive association with the NSSI occurrence. For the 8th grade students' alcohol use and being a bully had also a positive association with the NSSI occurrence. Safety perception at school had a negative association with the NSSI occurrence for the 8th grade students. Specific strategies that address the NSSI occurrence in adolescents are needed for Portuguese adolescents and those needs presented age (grade) and sex specificities. Public policies must take these specificities on board while designing and implementing preventive interventions with families, in the school and in the community in order to promote a safer environment at school and adolescents' positive
International prevalence of adolescent non-suicidal self-injury and deliberate self-harm
Child and Adolescent Psychiatry and Mental Health, 2012
Background: The behaviours of non-suicidal self-injury (NSSI) and deliberate self-harm (DSH) are prevalent among adolescents, and an increase of rates in recent years has been postulated. There is a lack of studies to support this postulation, and comparing prevalence across studies and nations is complicated due to substantial differences in the methodology and nomenclature of existing research. Methods: We conducted a systematic review of current (2005 -2011) empirical studies reporting on the prevalence of NSSI and DSH in adolescent samples across the globe. Results: Fifty-two studies fulfilling the inclusion criteria were obtained for analysis. No statistically significant differences were found between NSSI (18.0% SD = 7.3) and DSH (16.1% SD = 11.6) studies. Assessment using single item questions led to lower prevalence rates than assessment with specific behaviour checklists. Mean prevalence rates have not increased in the past five years, suggesting stabilization. Conclusion: NSSI and DSH have a comparable prevalence in studies with adolescents from different countries. The field would benefit from adopting a common approach to assessment to aide cross-cultural study and comparisons.
Journal of Abnormal Child Psychology, 2013
Previous prevalence rates of non-suicidal selfinjury (NSSI) in adolescents have varied considerably. In the present cross-sectional study, prevalence rates, characteristics and functions of NSSI were assessed in a large randomized community sample consisting of 3,060 (50.5 % female) Swedish adolescents aged 15-17 years. The suggested criteria for NSSI disorder in the Diagnostic and Statistical Manual of Mental Disorders, 5th edition, (DSM-5) were used to assess prevalence rates with the aim of arriving at a more precise estimate. Out of the whole sample, 1,088 (35.6 %) adolescents (56.2 % female) reported at least one episode of NSSI during the last year, of which 205 (6.7 %) met suggested DSM-5 criteria for a potential NSSI disorder diagnosis. The NSSI disorder diagnosis was significantly more common in girls (11.1 % vs. 2.3 %, χ 2 (1, N=3046) = 94.08, p<0.001, cOR=5.43, 95 % CI [3.73, 7.90]). The NSSI disorder group consisted of significantly more smokers and drug users compared to adolescents with NSSI that did not meet DSM-5 criteria for NSSI disorder, and also differed concerning demographic variables. A confirmatory factor analysis (CFA) was conducted on reported functions of NSSI, with the aim of validating Nock and Prinstein's ) four-factor model on a Swedish community sample, resulting in a close to acceptable fit. A two-factor model (social and automatic reinforcement) resulted in a slightly better fit. The most frequently reported factors were positive and negative automatic reinforcement. A majority of functions were significantly more often reported by girls than boys. The implications of the suggested DSM-5 criteria and reported functions are discussed.
Suicide in Italian children and adolescents
Journal of Affective Disorders, 2009
Background: Data and statistics on suicide mortality in several countries have been published and discussed over the last few decades but gaps in knowledge are present in the epidemiology of suicide among Italian youths. Methods: Suicide mortality data for the years 1973-2002 were obtained from the Italian Central Institute of Statistics (ISTAT). Age-standardized mortality rates were calculated and examined for trends over time.
European Child & Adolescent Psychiatry, 2009
j Abstract Objective Self-injury (SI), self-injurious behaviour (SIB), including suicidal or nonsuicidal self-injury (SSI, NSSI) represent an increasing problem among teenagers amounting to a 6-17% prevalence rate in adolescence, yet little data exists on detailed characteristics and associated factors of SI reaching clinical severity. There is also a scarcity of data distinguishing between suicidal and non-suicidal subsamples of self-injuring patients, i.e. showing which predictors contribute to develop selfinjurious behaviour with a previous suicidal history (SSI). Method Clinical diagnoses and characteristics of risk behaviour were examined in a crosssectional design in suicidal and non-suicidal subgroups of Hungarian adolescent outpatients practising selfinjurious behaviour. From the total pool of 708 new patients consecutively referred with various psychiatric problems in five regional child psychiatric centres in Western-Hungary over an 18month period, 105 adolescent outpatients suffering from selfinjurious behaviour participated in the study (28 males and 77 females aged from 14 to 18 years, mean age 15.97, SD 1.05). The Ottawa/Queen's self-injury questionnaire (OSI) was used to mea-sure the characteristics of risk behaviour, while the comorbid clinical diagnoses were confirmed by the M.I.N.I. Plus International Neuropsychiatric Interview. Descriptive statistics presented the frequencies of the characteristics of SI, bilateral comparisons were used to reveal relevant items to differentiate between sex, duration of practice and SSI versus NSSI and logistic regression was performed to identify significant predictors of suicidal subtype of selfinjuring practice. Results A total of 60% of the clinical SI population experienced a present or past episode of major depression. The motivation of patients to resist impulses and to discontinue malpractice was low. Cutting and scratching was the most common self-injuring methods. Two-thirds of the sample practised the impulsive type of SI, while 30% practised premeditated SI having an incubation time from 30 min to days and weeks before carrying out SI. Although duration of SI did not distinguish the sample in important aspects, girls and boys differed in several aspects of SI practice. SSI adolescents differed from their NSSI peers in a number of important characteristics including the frequency of actions, injured areas, methods, specific stresses and motivations. SSI ado-