Samookaleczenie/cięcie się

Samookaleczenie/cięcie się
Epidemiologia

Niesamobójcze samouszkodzenie (NSSI) definiowane jest jako celowe uszkodzenie tkanki ciała bez intencji samobójczych, najczęściej w formie cięcia skóry, przypalania lub zadrapywania. Epidemiologia wskazuje na rozpowszechnienie NSSI w populacji młodzieży na poziomie 16-22%, ze szczytem zachorowań w wieku około 13-16 lat, a u dorosłych wskaźniki są niższe (1-6%). Istotne różnice występują między płciami – dziewczęta wykazują wyższe ryzyko (22,9% vs. 13,7% u chłopców). NSSI występuje globalnie, z wyższą częstością w krajach azjatyckich (19,5%) oraz wśród grup szczególnie narażonych, takich jak osoby ze spektrum autyzmu (do 42%), studenci (17-35%), migranci, osoby LGBTQ+ oraz populacje więzienne. Najczęstszą metodą jest cięcie (70% przypadków), a głównym wyzwalaczem – poczucie odrzucenia. NSSI jest silnie powiązane z zaburzeniami psychicznymi, w tym depresją, lękiem, zaburzeniem osobowości borderline oraz nadużywaniem substancji, a także stanowi istotny czynnik ryzyka prób samobójczych (5-krotnie wyższe ryzyko myśli samobójczych i 10-krotnie prób samobójczych).

Epidemiologia samookaleczenia/cięcia się

Samookaleczenie/cięcie się, określane też jako niesamobójcze samouszkodzenie (ang. non-suicidal self-injury, NSSI), definiuje się jako celowe uszkodzenie tkanki ciała bez intencji samobójczych, wykonywane w celach niepodlegających społecznej akceptacji¹. Najczęściej przyjmuje formę nacinania/cięcia skóry, przypalania i dotkliwego zadrapywania²³. Zjawisko to stanowi poważny problem zdrowia publicznego o znaczeniu globalnym, wywierający głęboki wpływ zarówno na jednostki, jak i społeczności⁴.

Rozpowszechnienie globalne

Metaanalizy dotyczące samookaleczeń wskazują, że rozpowszechnienie niesamobójczych samouszkodzeń wśród młodzieży wynosi średnio około 16-22%⁵⁶. Według metaanalizy z 2015 roku przeprowadzonej wśród 600 000 nastolatków, rozpowszechnienie niesamobójczych samouszkodzeń w całym życiu wynosi 22,9%, a włączając samouszkodzenia zarówno o charakterze samobójczym, jak i niesamobójczym (z wyłączeniem samozatruć) – 16,9%⁷.

W badaniach na populacji ogólnej zaobserwowano, że współczynniki występowania NSSI wynoszą około 7,7% wśród młodszych nastolatków (klasy 6-8) oraz 13,9-21,4% wśród uczniów szkół średnich (klasy 9-12)⁸. Co istotne, samookaleczenia występują również u dzieci – badania wykazały, że zachowania te są zgłaszane już przez dzieci w wieku 7 lat⁹.

W populacji dorosłych wskaźniki występowania NSSI są niższe niż u nastolatków. Szacuje się, że wynoszą one około 1-6% w populacji ogólnej dorosłych w Stanach Zjednoczonych¹⁰¹¹. Należy jednak zaznaczyć, że badania oparte wyłącznie na przyjęciach do szpitali mogą nie uwzględniać większej grupy osób dokonujących samouszkodzeń, które nie wymagają lub nie poszukują leczenia szpitalnego¹².

Różnice płciowe

Większość badań wskazuje na istotne różnice w rozpowszechnieniu samookaleczeń między płciami. Metaanaliza z lat 2015-2020 wykazała znaczącą różnicę w rozpowszechnieniu samookaleczeń między dziewczętami (19,4%) a chłopcami (12,9%)¹³. Jeszcze większe dysproporcje obserwowano przy uwzględnieniu tylko rozpowszechnienia w ciągu życia: 22,9% dla dziewcząt i 13,7% dla chłopców¹⁴.

Szczególnie narażone na samookaleczenia są dziewczęta w wieku 15-19 lat, które stanowią grupę najczęściej hospitalizowaną z powodu samouszkodzeń (około 15% wszystkich hospitalizacji z powodu samookaleczeń)¹⁵. W badaniu młodzieży w 11 stanach USA wykazano, że dziewczęta dwukrotnie częściej niż chłopcy zgłaszały NSSI w ciągu ostatniego roku (23,8% vs. 11,3%)¹⁶.

W przypadku nastolatków z 9 klasy, różnice między płciami są jeszcze bardziej wyraźne – dziewczęta z 9 klasy dokonują samookaleczeń trzy razy częściej niż chłopcy w tym samym wieku¹⁷.

Różnice wiekowe

Zachowania samookaleczające najczęściej pojawiają się w okresie dojrzewania, choć nie ma zgodności co do tego, czy występują one częściej przed pokwitaniem czy w późniejszym okresie dojrzewania¹⁸. Badania wskazują, że średni wiek rozpoczęcia samookaleczeń u nastolatków to około 13 lat, natomiast szczyt nasilenia przypada na 16 rok życia¹⁹.

Z badań wynika, że częstość występowania NSSI zmniejsza się wraz z wiekiem nastolatków – 19,4% 14-latków zgłaszało NSSI w ciągu ostatniego roku, w porównaniu do 14,7% 18-latków²⁰. Jednocześnie zaobserwowano, że wskaźniki samookaleczeń gwałtownie wzrastają przy przejściu z dzieciństwa do okresu dojrzewania, szczególnie u dziewcząt²¹.

Badania wskazują również, że rozpowszechnienie NSSI różni się w zależności od poziomu edukacji – odnotowano NSSI u 7,6% uczniów trzeciej klasy, 4,0% uczniów szóstej klasy i 12,7% uczniów dziewiątej klasy²².

Różnice kulturowe i geograficzne

NSSI występuje w niemal wszystkich kulturach i grupach etnicznych, jednak wskaźniki występowania, czynniki przyczyniające się, funkcje i metody NSSI mogą różnić się w zależności od kultury i kontekstu²³. Choć badania w krajach niezachodnich są ograniczone w porównaniu z krajami zachodnimi, wskaźniki rozpowszechnienia NSSI w ciągu życia zgłaszano wśród młodych dorosłych w Chinach (23%), Belgii (8%), Indiach (21%), Turcji (15-33%), Meksyku (17-19%) i USA (12-23%)²⁴.

Metaanaliza z lat 2015-2020 wykazała, że łączny wskaźnik z krajów azjatyckich (19,5%) był znacznie wyższy niż z innych kontynentów (14,6%)²⁵. Istnieją również dowody na zwiększone rozpowszechnienie NSSI wśród migrantów i uchodźców w porównaniu z populacjami krajów przyjmujących²⁶.

W badaniu młodzieży w USA stwierdzono, że rdzenni Amerykanie wydają się być w większym stopniu narażeni na NSSI – ponad 20% zgłaszało NSSI w ciągu ostatniego roku, w porównaniu do 17,7% białej młodzieży i 12,1% czarnej młodzieży²⁷.

Populacje szczególnego ryzyka

Badania identyfikują kilka grup demograficznych o podwyższonym ryzyku samookaleczeń:

Osoby ze spektrum autyzmu – wykazano, że ryzyko samouszkodzeń u osób z ASD jest ponad trzykrotnie wyższe niż u osób bez ASD²⁸. Rozpowszechnienie zachowań samouszkadzających, takich jak uderzanie się w rękę, samookaleczanie czy wyrywanie włosów, sięga nawet 42% w populacji osób z autyzmem²⁹.
Studenci – badania wskazują na zwiększone ryzyko NSSI wśród studentów uczelni wyższych w porównaniu z populacją ogólną, gdzie wskaźniki wahają się od 17 do 35%³⁰.
Populacja osób osadzonych – celowe samookaleczenia są szczególnie rozpowszechnione w populacjach więziennych³¹.
Osoby identyfikujące się jako biseksualne lub kwestionujące swoją orientację seksualną – są one znacznie bardziej narażone na samookaleczenia w porównaniu z rówieśnikami heteroseksualnymi i homoseksualnymi; prawidłowość ta jest szczególnie widoczna u kobiet³².
Młodzież z problemami zdrowia psychicznego – wykazano, że młodzież i dorośli z chorobami psychicznymi mają najwyższy wskaźnik występowania NSSI³³.

Trendy w samookaleczeniach

Analizy trendów w zakresie samookaleczeń dostarczają cennych informacji na temat zmian w częstości występowania tego zjawiska na przestrzeni lat, co ma kluczowe znaczenie dla planowania odpowiednich usług zdrowotnych i oceny skuteczności polityk zarządzania i zapobiegania³⁴.

Zmiany czasowe

Metaanalizy wskazują, że rozpowszechnienie samookaleczeń wykazywało znaczący wzrost w latach 90. XX wieku, po czym nastąpiła stagnacja od 2005 roku³⁵. W latach 80. i 90. XX wieku zaobserwowano gwałtowny wzrost liczby osób leczonych w szpitalach w Europie, Stanach Zjednoczonych i Australii z powodu celowych przedawkowań lub samouszkodzeń³⁶.

W wieloośrodkowym badaniu przeprowadzonym w Anglii w latach 2000-2012 zaobserwowano, że wskaźniki samookaleczeń zmniejszyły się u kobiet (IRR 0,98; 95% CI 0,97 do 0,99, p≤0,0001). U mężczyzn wskaźniki samookaleczeń zmniejszyły się do 2008 roku (IRR 0,96; 95% CI 0,95 do 0,98, p≤0,0001), a następnie wzrosły (IRR 1,05; 95% CI 1,02 do 1,09, p=0,002)³⁷.

W badaniu przeprowadzonym w trzech ośrodkach w Anglii w latach 2000-2007 wskaźniki samookaleczeń spadły znacząco w ciągu 8 lat u mężczyzn (Oxford: 14%; Manchester: 25%; Derby: 18%) i kobiet w dwóch ośrodkach (Manchester: 13%; Derby: 17%)³⁸. Spadek ten był zgodny z krajowymi trendami dotyczącymi samobójstw w Anglii w tym okresie³⁹.

W ostatnich latach wykazano znaczący wzrost samouszkodzeń przez samookaleczenie w późniejszym okresie badań w Anglii (2000-2012), co było szczególnie widoczne w przypadku samookaleczenia/dźgania i powieszenia/uduszenia⁴⁰. Trend ten zbiegł się z recesją gospodarczą, która rozpoczęła się w 2008 roku⁴¹.

Metody samookaleczeń

Cięcie jest najczęstszą formą NSSI, gdzie nawet 70% pacjentów z NSSI deklaruje, że stosowało tę formę w przeszłości⁴². W badaniu przeprowadzonym w Wyoming w latach 2016-2019 zaobserwowano, że około 9 na 10 hospitalizacji z powodu samouszkodzeń było związanych z celowym przedawkowaniem leków (określanym również jako zatrucie lekami)⁴³.

Badanie przeprowadzone w Kenii wykazało, że większość zgłoszonych przypadków samookaleczeń dotyczyła incydentów przedawkowania (68,8%), a samookaleczenia stanowiły 56,3% przypadków. W kontekście samookaleczeń, cięcie było dominującą formą⁴⁴.

Inne częste metody samouszkodzeń obejmują przypalanie się, wyrywanie włosów i uderzanie samego siebie⁴⁵. Najczęstszym „wyzwalaczem” samookaleczenia jest poczucie odrzucenia: przez obiekt romantycznych uczuć, przez bliskich przyjaciół lub ogólne poczucie bycia pominiętym lub krytykowanym⁴⁶.

Czynniki ryzyka

Badania zidentyfikowały szereg czynników ryzyka związanych z NSSI:

Płeć żeńska – kobiety są bardziej narażone na samookaleczenia niż mężczyźni⁴⁷.
Wczesny wiek nastoletni – samookaleczenia często rozpoczynają się we wczesnych latach nastoletnich⁴⁸.
Przebywanie wśród osób lub przyjaciół, którzy się samookaleczają – badania sugerują, że NSSI może być społecznie zaraźliwe wśród nastolatków⁴⁹.
Problemy ze zdrowiem psychicznym – samookaleczający się często cierpią z powodu słabych umiejętności radzenia sobie i/lub zaburzeń psychicznych (np. depresji, lęku, stresu pourazowego)⁵⁰.
Wpływ alkoholu lub narkotyków – samookaleczający się często wyrządzają sobie krzywdę pod wpływem alkoholu lub narkotyków⁵¹.
Inne czynniki ryzyka obejmują: depresję (także u rodziców), zaburzenia lękowe, nadużywanie substancji, zaburzenie osobowości borderline, zespół stresu pourazowego, trudności w relacjach interpersonalnych oraz problemy z samoregulacją u rodziców⁵².

Związek z zachowaniami samobójczymi

Związek między samookaleczeniami a zachowaniami samobójczymi jest złożony. Chociaż osoby dokonujące niesamobójczych samouszkodzeń nie mają zamiaru odebrać sobie życia⁵³, badania wskazują, że NSSI jest czynnikiem ryzyka późniejszych prób samobójczych⁵⁴.

Badania wykazały, że nastolatek, który dokonuje samookaleczenia, jest pięciokrotnie bardziej narażony na myśli samobójcze oraz dziesięciokrotnie bardziej narażony na próbę samobójczą⁵⁵. Ryzyko to wzrasta wraz ze wzrostem częstotliwości samookaleczeń. Ogólnie rzecz biorąc, prawie 1 na 3 nastolatków (30%), którzy dokonują samookaleczeń, zgłosiło próbę samobójczą⁵⁶.

Według badań, około 65% młodzieży, która dokonuje samookaleczeń, będzie również wykazywała skłonności samobójcze w pewnym momencie życia (choć wielu nie wykroczy poza myśli samobójcze)⁵⁷. Również sam akt angażowania się w samookaleczenia zmniejsza zahamowania przed zachowaniami samobójczymi, jeśli dana osoba stanie się samobójcza⁵⁸.

Systemy nadzoru i monitorowanie

Skuteczny nadzór nad samookaleczeniami ma kluczowe znaczenie dla zrozumienia obciążenia i zmian w czasie. Systemy nadzoru zdrowia publicznego oferują niezbędne dane dotyczące rozpowszechnienia, częstości występowania i cech stanów zdrowotnych⁵⁹.

Systemy monitorowania samookaleczeń

Dane dotyczące śmiertelnych samookaleczeń (samobójstw) są systematycznie gromadzone, jednak dane dotyczące nieśmiertelnych samookaleczeń nie są systematycznie zbierane i raportowane na poziomie krajowym, stanowym lub lokalnym w większości krajów⁶⁰. Wyjątkiem jest Irlandia, gdzie utworzono Krajowy Rejestr Celowych Samookaleczeń⁶¹.

Nadzór nad samookaleczeniami i urazami wszystkich typów jest często prowadzony poprzez monitorowanie wizyt na oddziałach ratunkowych i hospitalizacji⁶². Od października 2015 r. w USA wszystkie podmioty objęte ustawą o przenośności i odpowiedzialności w ubezpieczeniach zdrowotnych (HIPAA) używają Międzynarodowej Klasyfikacji Chorób, 10. Rewizji, Modyfikacji Klinicznej (ICD-10-CM) przy raportowaniu informacji o opiece medycznej⁶³.

W 2019 roku Centra Kontroli i Zapobiegania Chorobom (CDC) w USA opublikowały zalecenia dotyczące definicji przypadku hospitalizacji z powodu urazu w oparciu o kody ICD-10-CM. Identyfikacja przypadków obejmujących celowe samookaleczenie wymaga przeglądu zarówno kodów diagnostycznych, jak i kodów zewnętrznych przyczyn, ponieważ niektóre przyczyny są odzwierciedlone w unikalnych kodach diagnostycznych (zatrucie, uduszenie i próba samobójcza), podczas gdy inne są odzwierciedlone w unikalnych kodach zewnętrznych przyczyn (wszystkie inne środki celowego samookaleczenia, takie jak cięcie lub broń palna)⁶⁴.

Wyzwania w monitorowaniu

Trudno jest uzyskać dokładny obraz częstości występowania i rozpowszechnienia samookaleczeń ze względu na różne wyzwania metodologiczne. Zarejestrowane dane mogą być oparte na trzech źródłach: próbkach psychiatrycznych, przyjęciach do szpitali i badaniach populacji ogólnej⁶⁵.

Jednym z ograniczeń jest to, że badanie obejmuje tylko osoby, które zgłosiły się do szpitala po samookaleczeniu. Wskaźniki samookaleczeń raportowane w badaniu są oparte na populacjach miejskich, które, jak wykazano, mają wyższe wskaźniki samookaleczeń niż populacje wiejskie⁶⁶.

Innym wyzwaniem jest to, że szerokie spektrum zachowań, które mieszczą się w kategorii zachowań samobójczych, obejmuje samookaleczenia o różnym poziomie intencji samobójczej, a także śmierć przez samobójstwo⁶⁷.

Znaczenie nadzoru

Skuteczne identyfikowanie trendów i populacji zagrożonych wymaga terminowego monitorowania i rejestracji samookaleczeń. Ulepszony nadzór nad danymi może ułatwić projektowanie ukierunkowanych interwencji i strategii dostosowanych do konkretnych potrzeb i kontekstów⁶⁸.

Dane zebrane za pośrednictwem systemów nadzoru odgrywają kluczową rolę, pomagając sektorom rządowym i opieki zdrowotnej identyfikować trendy i potrzeby epidemiologiczne, informując o rozwoju strategii zdrowia publicznego i interwencji zapobiegających samobójstwom⁶⁹.

Monitorowanie i ocena mają kluczowe znaczenie dla ciągłej istotności i wpływu na wysiłki prewencyjne⁷⁰. Na przykład, w Kenii pilotażowy rejestr samookaleczeń został utworzony w Szpitalu Uniwersyteckim Aga Khan w Nairobi w 2023 roku w celu wsparcia rozwoju krajowego rejestru samookaleczeń i samobójstw⁷¹.

Implikacje dla zdrowia publicznego

Samookaleczenia stanowią poważny problem zdrowia publicznego o licznych implikacjach dla systemów opieki zdrowotnej, społeczeństw i jednostek.

Obciążenie systemów opieki zdrowotnej

Samookaleczenia są częstą przyczyną wizyt na oddziałach ratunkowych i hospitalizacji. Około 10% przyjęć na oddziały medyczne w Wielkiej Brytanii wynika z samookaleczeń, z których większość to przedawkowania leków⁷². W USA przez ponad dekadę samouszkodzenia przez zatrucie znajdowały się wśród pięciu głównych przyczyn wizyt na oddziałach ratunkowych skutkujących hospitalizacją (wszystkie grupy wiekowe) i na drugim miejscu wśród osób w wieku 15-24 lat⁷³.

W badaniu przeprowadzonym w jednym szpitalu miejskim w USA w ciągu rocznego okresu badania odnotowano 2028 wypisów z oddziału ratunkowego z powodu samouszkodzeń, co stanowiło 0,35% wszystkich wypisów. Roczny wskaźnik wyniósł 66 na 100 000. 32% wszystkich wypisów z powodu samouszkodzeń dotyczyło cięcia (21 na 100 000)⁷⁴.

Związek z innymi problemami zdrowia psychicznego

Samookaleczenia są związane z szeregiem trudności psychiatrycznych⁷⁵ i często współwystępują z innymi problemami zdrowia psychicznego. W badaniu przeprowadzonym na oddziale ratunkowym w USA stwierdzono, że 66% osób z samookaleczeniami przez cięcie zdiagnozowano chorobę psychiczną, a 30% – używanie/nadużywanie alkoholu⁷⁶.

Badania wykazały, że nastolatki, które dokonują samouszkodzeń, mają wyższe wskaźniki lęku i depresji niż ich rówieśnicy, którzy nie dokonują samouszkodzeń⁷⁷. Zaobserwowano również związek między nadużywaniem narkotyków (w tym alkoholu) i zaburzeniami odżywiania a samookaleczeniami⁷⁸.

Znaczenie dla prewencji

Zrozumienie epidemiologii samookaleczeń ma kluczowe znaczenie dla opracowania skutecznych strategii profilaktycznych. Badania sugerują, że trendy w zakresie samookaleczeń i samobójstw mogą być ściśle powiązane; dlatego samookaleczenia mogą być użytecznym wskaźnikiem zdrowia psychicznego⁷⁹.

Wyniki badań sugerują, że inicjatywy profilaktyczne podjęte w Anglii po wprowadzeniu krajowej strategii w 2002 roku, prawdopodobnie wraz z korzystnymi czynnikami społecznymi, mogły mieć pozytywny wpływ na zmniejszenie zarówno samookaleczeń, jak i samobójstw⁸⁰.

W Stanach Zjednoczonych redukcja samookaleczeń wśród młodzieży w wieku 10-19 lat jest kluczowym obszarem działań w zakresie zapobiegania samobójstwom finansowanych przez grant Centrów Kontroli i Zapobiegania Chorobom (CDC)⁸¹.

Potrzeby badawcze

Genetyczna epidemiologia samobójstw i samookaleczeń pozostaje słabo poznana⁸². Badania genetyczne sugerują, że wariancja uchwycona przez polimorfizmy pojedynczego nukleotydu (SNP) jest niewielka, a większa proporcja wspólnej zmienności genetycznej wyjaśniona jest dla NSSI niż dla prób samobójczych (SA)⁸³.

Badania nad samookaleczeniami w krajach rozwijających się są wciąż bardzo ograniczone⁸⁴. Potrzeba więcej badań nad samookaleczeniami wśród starszych osób, ponieważ tylko garstka badań odnosi się do samookaleczeń w tej grupie wiekowej⁸⁵.

Dalsze badania powinny mieć na celu określenie wpływu współwystępujących diagnoz, opracowanie systemów nadzoru nad urazami dla populacji osób z autyzmem oraz wdrożenie skutecznych strategii profilaktycznych w celu zapewnienia bezpieczeństwa i dobrostanu osobom z ASD⁸⁶.

Populacja	Rozpowszechnienie NSSI	Główne czynniki ryzyka
Dzieci (7-12 lat)	7,6% (trzecia klasa)	Historia rodzinna, problemy psychiczne, doświadczenia traumatyczne
Wczesna adolescencja (13-15 lat)	7,7-12,7%	Płeć żeńska, depresja, lęk, trudności w relacjach
Późna adolescencja (16-19 lat)	13,9-21,4%	Płeć żeńska, problemy psychiczne, używanie substancji psychoaktywnych
Studenci	17-35%	Stres akademicki, problemy adaptacyjne, trudności w relacjach
Dorośli (populacja ogólna)	1-6%	Zaburzenia psychiczne, uzależnienia, traumy
Osoby ze spektrum autyzmu	Do 42%	Trudności w regulacji emocji, problemy sensoryczne
Migranci i uchodźcy	Wyższe niż w populacji kraju przyjmującego	Trudności adaptacyjne, traumy, doświadczenie dyskryminacji
Społeczność LGBTQ+	Wyższe niż w populacji heteroseksualnej	Stygmatyzacja, odrzucenie, problemy z akceptacją

Kolejne rozdziały

Zapraszamy do dalszego czytania naszego leksykonu.

Wybierz kolejny rozdział z menu poniżej, aby otworzyć nową podstronę kompedium wiedzy i uzyskać szczegółowe informację o leku, substancji lub chorobie.

Materiały źródłowe

#1 Nonsuicidal self-injury in children and adolescents: Epidemiology and risk factors – UpToDate
https://www.uptodate.com/contents/nonsuicidal-self-injury-in-children-and-adolescents-epidemiology-and-risk-factors/print
Nonsuicidal self-injury is the deliberate destruction of body tissue in the absence of any intent to die and occurs for purposes that are not socially sanctioned. The behavior most commonly takes the form of skin-cutting, burning, and severe scratching. Nonsuicidal self-injury occurs at high rates in adolescents and is associated with adverse clinical outcomes such as suicide attempts. […] This topic discusses the epidemiology and risk factors for nonsuicidal self-injury, and focuses primarily upon adolescents because the behavior occurs far more often in this age group than in children.
#2 Nonsuicidal self-injury in children and adolescents: Epidemiology and risk factors – UpToDate
https://www.uptodate.com/contents/nonsuicidal-self-injury-in-children-and-adolescents-epidemiology-and-risk-factors/print
Nonsuicidal self-injury is the deliberate destruction of body tissue in the absence of any intent to die and occurs for purposes that are not socially sanctioned. The behavior most commonly takes the form of skin-cutting, burning, and severe scratching. Nonsuicidal self-injury occurs at high rates in adolescents and is associated with adverse clinical outcomes such as suicide attempts. […] This topic discusses the epidemiology and risk factors for nonsuicidal self-injury, and focuses primarily upon adolescents because the behavior occurs far more often in this age group than in children.
#3 Self-Injury: Why Kids Cut Themselves & How to Help | Child Mind Institute
https://childmind.org/article/what-drives-self-injury-and-how-to-treat-it/
When a person develops a habit of cutting their arms it might look like suicidal behavior, but it actually isnât. People who self-injure arenât trying to kill themselves, they are trying to alleviate some emotional distress they are feeling. However, the behavior indicates a depth of psychic pain that could lead to a suicide attempt. The behavior is also inherently dangerous because people who self-injure may hurt themselves more seriously than intended or develop infections or other medical complications. […] Experts call it âself-injury,â and as many as a quarter of all teenagers do it. […] The most common form of self-injury is cutting or scratching the skin with anything that can draw blood, such as razors or even paperclips and pen caps, but people also self-injure by burning themselves, picking at skin and wounds, or hitting themselves. They often start around puberty.
#4 Patterns of self-harm presentations at a Tertiary Urban Hospital in Kenya: A retrospective 5-year study (2018â2022) | PLOS One
https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0317981
Self-harm represents a complex and multifaceted public health issue of global significance, exerting profound effects on individuals and communities alike. It involves intentional self-poisoning or self-injury with or without the motivation to die. […] Although self-harm is highly prevalent, limited research has focused on the patterns and trends of self-harm among hospital populations in low- and middle-income countries, particularly within Africa. This study aims to explore the socio-demographic and clinical profile of patients presenting with self-harm and determine the common self-harm patterns at a tertiary facility in Kenya. […] A total of 507 files were reviewed in the given timeframe and 497 patients were included in the analysis. Of these patients, 28.1% (n = 144) presented with self-harm.
#5
https://link.springer.com/article/10.1007/s00787-023-02264-y
In the past 10 years, there has been a growing interest in self-injurious behavior (SIB) among adolescents. The lifetime prevalence of SIB is between 16 and 22% in community sample with females more likely to engage in SIB. […] The overall average prevalence of nonsuicidal self-injury in the studies was 16%. There was a significant gender difference: females reported a higher prevalence than males (19.4% and 12.9%, respectively). […] The current research draws attention to the high prevalence of SIB among adolescents, especially among females and those living in Asia. It is important to address this behavior, both in terms of prevention and intervention. […] Based on the previous meta-analyses, the prevalence of SIB shows a significant increase in the 1990s, but then a stagnation from 2005.
#6
https://link.springer.com/article/10.1007/s00787-023-02264-y
According to previous meta-analyses, between 1990 and 2015, the average lifetime prevalence of SIB among adolescents is between 16.9 and 19.7%. […] Our first hypothesis was that the prevalence of SIB did not change over time between the examined period (2015 and 2020) for both females and males. Our second hypothesis was that females reported a higher prevalence of a history of SIB than males. […] In the present meta-analysis, we found that the prevalence of SIB in adolescents was 16% in studies published between 2015 and 2020. […] We found a substantial difference between the estimates for females (19.4%) and males (12.9%), with nonoverlapping confidence intervals. A similar pattern was observed when we considered only lifetime prevalence, with 22.9% for females and 13.7% for males.
#7 Self-harm – Wikipedia
https://en.wikipedia.org/wiki/Self-harm
It is difficult to gain an accurate picture of incidence and prevalence of self-harm. […] Recorded figures can be based on three sources: psychiatric samples, hospital admissions and general population surveys. […] A 2015 meta-analysis of reported self-harm among 600,000 adolescents found a lifetime prevalence of 11.4% for suicidal or non-suicidal self-harm (i.e. excluding self-poisoning) and 22.9% for non-suicidal self-injury (i.e. excluding suicidal acts), for an overall prevalence of 16.9%. […] The World Health Organization estimates that, as of 2010, 880,000 deaths occur as a result of self-harm (including suicides). […] About 10% of admissions to medical wards in the UK are as a result of self-harm, the majority of which are drug overdoses. […] However, studies based only on hospital admissions may hide the larger group of self-harmers who do not need or seek hospital treatment for their injuries, instead treating themselves.
#8 Rates of Nonsuicidal Self-Injury in Youth: Age, Sex, and Behavioral Methods in a Community Sample
https://pmc.ncbi.nlm.nih.gov/articles/PMC3382916/
In community samples, 7.7% of early adolescents (grades 6-8, n = 508) reported engaging in NSSI and 13.9% to 21.4% of high school adolescents (grades 9-12, mean age 16) reported NSSI. […] Engaging in NSSI is a risk factor for suicidal thoughts and behaviors and a precursor to more serious psychopathology. […] Given likely inclusion in the official psychiatric nomenclature, it is important to establish rates and behavioral methods used to self-injure among children and adolescents. […] This study aimed to answer the following questions: (1) What are the lifetime rates of NSSI in a general community sample of children and adolescents (ages 7-16)? (2) Are there gender and/or age differences in NSSI rates? (3) What methods are used by youth engaging in NSSI, and do these methods vary by gender or age?
#9 Rates of Nonsuicidal Self-Injury in Youth: Age, Sex, and Behavioral Methods in a Community Sample
https://pmc.ncbi.nlm.nih.gov/articles/PMC3382916/
The goal was to assess the rate and behavioral methods of nonsuicidal self-injury (NSSI) in a community sample of youth and examine effects of age and sex. […] Overall, 53 (8.0%) of the 665 youth reported engaging in NSSI; 9.0% of girls and 6.7% of boys reported NSSI engagement; 7.6% of third-graders, 4.0% of sixth-graders, and 12.7% of ninth-graders reported NSSI engagement. […] Children and adolescents engage in NSSI. Ninth-grade girls seem most at risk, as they engage in NSSI at 3 times the rate of boys. […] Known rates of nonsuicidal self-injury, hurting oneself without the intent to die, are between 7% and 24% in samples of early adolescents and older adolescents, yet research has not reported rates for youth younger than 11 years old. […] Children as young as 7 years old report engaging in nonsuicidal self-injury.
#10 Nonsuicidal Self-Injury DSM-5
https://www.theravive.com/therapedia/nonsuicidal-self–injury-dsm–5
NSSI has a prevalence rate of about 1 to 4 percent in the adult population in the United States (Kerr, Muehlenkamp, Turner, 2010) Furthermore the extremely severe form of self-injury is seen in about 1 percent of the population (Kerr, Muehlenkamp, Turner, 2010). […] Though some research has indicated a lifetime prevalence of NSSI being as high as 5.9 percent and an increased 2.7 percent that have self injured greater than five times (Klonsky, 2011). […] NSSI is more common among teenagers, with a reported 15 percent admitting to some type of self-injury (Kerr, Muehlenkamp, Turner, 2010). […] Furthermore, there is a greater risk for NSSI among college students when compared to the general population, where rates range from 17 to 35 percent. […] Cutting is the most common form of NSSI, where as much as 70 percent of NSSI patients, state that they have used the cutting form in the past.
#11 Self-injury (Cutting, Self-Harm or Self-Mutilation) | Mental Health America
https://mhanational.org/conditions/self-injury-cutting-self-harm-or-self-mutilation/
Self-injury, also known as self-harm, self-mutilation, or self-abuseâoccurs when someone repeatedly harms themselves on purpose in a way that is impulsive and not intended to be lethal. While self-harm is not intended to be lethal, people who harm themselves are at a higher risk of attempting suicide if they do not receive help. […] Research indicates that self-injury occurs in approximately 5% of adults in the United States. Rates are higher among adolescents, with approximately 17% of teens reporting some form of self-injury. Studies show an even higher risk for self-injury among college students, with rates ranging from 17-35%. […] The relationship between suicide and self-injury is complicated. While people with non-suicidal self injury do not intend to complete suicide, they may cause more harm than intended, which could result in medical complications or death. In severe or long-term cases of self-injury, a person may become desperate about their lack of control over the behavior and its addictive nature, which may lead them to purposefully attempt suicide.
#12 Self-harm – Wikipedia
https://en.wikipedia.org/wiki/Self-harm
It is difficult to gain an accurate picture of incidence and prevalence of self-harm. […] Recorded figures can be based on three sources: psychiatric samples, hospital admissions and general population surveys. […] A 2015 meta-analysis of reported self-harm among 600,000 adolescents found a lifetime prevalence of 11.4% for suicidal or non-suicidal self-harm (i.e. excluding self-poisoning) and 22.9% for non-suicidal self-injury (i.e. excluding suicidal acts), for an overall prevalence of 16.9%. […] The World Health Organization estimates that, as of 2010, 880,000 deaths occur as a result of self-harm (including suicides). […] About 10% of admissions to medical wards in the UK are as a result of self-harm, the majority of which are drug overdoses. […] However, studies based only on hospital admissions may hide the larger group of self-harmers who do not need or seek hospital treatment for their injuries, instead treating themselves.
#13
https://link.springer.com/article/10.1007/s00787-023-02264-y
According to previous meta-analyses, between 1990 and 2015, the average lifetime prevalence of SIB among adolescents is between 16.9 and 19.7%. […] Our first hypothesis was that the prevalence of SIB did not change over time between the examined period (2015 and 2020) for both females and males. Our second hypothesis was that females reported a higher prevalence of a history of SIB than males. […] In the present meta-analysis, we found that the prevalence of SIB in adolescents was 16% in studies published between 2015 and 2020. […] We found a substantial difference between the estimates for females (19.4%) and males (12.9%), with nonoverlapping confidence intervals. A similar pattern was observed when we considered only lifetime prevalence, with 22.9% for females and 13.7% for males.
#14
https://link.springer.com/article/10.1007/s00787-023-02264-y
According to previous meta-analyses, between 1990 and 2015, the average lifetime prevalence of SIB among adolescents is between 16.9 and 19.7%. […] Our first hypothesis was that the prevalence of SIB did not change over time between the examined period (2015 and 2020) for both females and males. Our second hypothesis was that females reported a higher prevalence of a history of SIB than males. […] In the present meta-analysis, we found that the prevalence of SIB in adolescents was 16% in studies published between 2015 and 2020. […] We found a substantial difference between the estimates for females (19.4%) and males (12.9%), with nonoverlapping confidence intervals. A similar pattern was observed when we considered only lifetime prevalence, with 22.9% for females and 13.7% for males.
#15 Self Harm Prevention – Wyoming Department of Health
https://health.wyo.gov/publichealth/prevention/wivpp/self-harm-awareness/
Self-harm is usually connected to high-levels of emotional distress that may happen because of: […] Wyoming hospitals reported that over 200 Wyomingites were hospitalized each year from 2016 to 2019 because of self-harm injuries. All together, more than 900 residents were hospitalized during that time. About every 9 out of 10 of these hospitalizations were reported to be because of an intentional drug overdose, also called a drug poisoning. Wyoming hospitals reported that adolescents age 15 to 19 were the most commonly admitted group because of self-harm injuries (15%, or 151 total) during 2016-2019. Hospitals also reported that over two-thirds of these teens hospitalized were female. In 2020 alone, hospitals around the US reported about 187,000 hospitalizations because of some method of self-harm. Globally, about 17% of all people are predicted to self-harm at some point in their life. Among teens, 17% are predicted to self-harm at least once. On average, cutting is reported to be the most common method of self-harm, and is found in almost half (45%) of all reports of self-harm around the world.
#16 Nonsuicidal Self-Injury among U.S. Adolescents – Suicide Prevention Resource Center
https://sprc.org/news/nonsuicidal-self-injury-among-u-s-adolescents/
A study of high school students in 11 U.S. states found that nearly 18% had engaged in at least one act of nonsuicidal self-injury (NSSI) in the past year. […] Using data from the Centers for Disease Control and Preventions Youth Risk Behavior Surveillance System, researchers examined rates of NSSI by demographic factors, such as age, race, and ethnicity. […] NSSI was measured by asking, 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? […] Researchers found that females were twice as likely to report NSSI in the past year compared to males (23.8% vs. 11.3%, respectively). […] NSSI appeared to decline with age, with 19.4% of 14-year-olds reporting past-year NSSI, compared to 14.7% of 18-year-olds.
#17 Rates of Nonsuicidal Self-Injury in Youth: Age, Sex, and Behavioral Methods in a Community Sample
https://pmc.ncbi.nlm.nih.gov/articles/PMC3382916/
The goal was to assess the rate and behavioral methods of nonsuicidal self-injury (NSSI) in a community sample of youth and examine effects of age and sex. […] Overall, 53 (8.0%) of the 665 youth reported engaging in NSSI; 9.0% of girls and 6.7% of boys reported NSSI engagement; 7.6% of third-graders, 4.0% of sixth-graders, and 12.7% of ninth-graders reported NSSI engagement. […] Children and adolescents engage in NSSI. Ninth-grade girls seem most at risk, as they engage in NSSI at 3 times the rate of boys. […] Known rates of nonsuicidal self-injury, hurting oneself without the intent to die, are between 7% and 24% in samples of early adolescents and older adolescents, yet research has not reported rates for youth younger than 11 years old. […] Children as young as 7 years old report engaging in nonsuicidal self-injury.
#18 Self-harm – Wikipedia
https://en.wikipedia.org/wiki/Self-harm
The onset of self-harm tends to occur around puberty, although scholarship is divided as to whether this is usually before puberty or later in adolescence. […] Meta-analyses have not supported some studies’ conclusion that self-harm rates are increasing among adolescents. […] The CASE (Child & Adolescent Self-harm in Europe) study suggests that the life-time risk of self-injury is ~1:7 for women and ~1:25 for men. […] Deliberate self-harm is common in the developing world. […] Research into self-harm in these areas is however, still very limited. […] Deliberate self-harm is especially prevalent in prison populations.
#19 Self Harm Prevention – Wyoming Department of Health
https://health.wyo.gov/publichealth/prevention/wivpp/self-harm-awareness/
Studies have found that, on average, teens will start to self-harm at age 13. These studies have also found that teens will self-harm more frequently and often at age 16. If a teen self-harms, they are five-times more likely to experience thoughts of suicide, also known as suicidal ideation. Teens are also found to be ten-times more likely to attempt suicide if they self-harm. These risks are greater the more frequently a teen self-harms. Overall, almost 1 in 3 teens (30%) that self-harm have reported a suicide attempt.
#20 Nonsuicidal Self-Injury among U.S. Adolescents – Suicide Prevention Resource Center
https://sprc.org/news/nonsuicidal-self-injury-among-u-s-adolescents/
A study of high school students in 11 U.S. states found that nearly 18% had engaged in at least one act of nonsuicidal self-injury (NSSI) in the past year. […] Using data from the Centers for Disease Control and Preventions Youth Risk Behavior Surveillance System, researchers examined rates of NSSI by demographic factors, such as age, race, and ethnicity. […] NSSI was measured by asking, 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? […] Researchers found that females were twice as likely to report NSSI in the past year compared to males (23.8% vs. 11.3%, respectively). […] NSSI appeared to decline with age, with 19.4% of 14-year-olds reporting past-year NSSI, compared to 14.7% of 18-year-olds.
#21 Rates of Nonsuicidal Self-Injury in Youth: Age, Sex, and Behavioral Methods in a Community Sample
https://pmc.ncbi.nlm.nih.gov/articles/PMC3382916/
This study was the first to address these important questions regarding NSSI in a general community sample of children and adolescents from grade school through high school. […] This study found that children engage in NSSI at a rate that is similar to early adolescents. […] Rates of NSSI surged dramatically from childhood into adolescence, especially for girls.
#22 Rates of Nonsuicidal Self-Injury in Youth: Age, Sex, and Behavioral Methods in a Community Sample
https://pmc.ncbi.nlm.nih.gov/articles/PMC3382916/
The goal was to assess the rate and behavioral methods of nonsuicidal self-injury (NSSI) in a community sample of youth and examine effects of age and sex. […] Overall, 53 (8.0%) of the 665 youth reported engaging in NSSI; 9.0% of girls and 6.7% of boys reported NSSI engagement; 7.6% of third-graders, 4.0% of sixth-graders, and 12.7% of ninth-graders reported NSSI engagement. […] Children and adolescents engage in NSSI. Ninth-grade girls seem most at risk, as they engage in NSSI at 3 times the rate of boys. […] Known rates of nonsuicidal self-injury, hurting oneself without the intent to die, are between 7% and 24% in samples of early adolescents and older adolescents, yet research has not reported rates for youth younger than 11 years old. […] Children as young as 7 years old report engaging in nonsuicidal self-injury.
#23 Self-Harm Awareness Month – USCRI
https://refugees.org/self-harm-awareness-month/
March is self-harm awareness month. Although less often talked about publicly, it is a common clinical problem that poses a significant public health concern. Research indicates that self-harm occurs in approximately 5% of adults, 17% of adolescents, and between 17% and 35% of college students in the U.S. (MHA, n.d.). […] NSSI exists in almost all cultures and ethnicities, but prevalence rates, contributing factors, functions, and methods of NSSI may be different across cultures and contexts. Although studies in non-Western countries are limited compared Western countries, lifetime prevalence rates of NSSI have been reported among young adults in China (23%), Belgium (8%), India (21%), Turkey (15-33%), Mexico (17-19%), and the U.S. (12-23%) (Gandhi et al., 2021; Mannekote Thippaiah et al., 2021).
#24 Self-Harm Awareness Month – USCRI
https://refugees.org/self-harm-awareness-month/
March is self-harm awareness month. Although less often talked about publicly, it is a common clinical problem that poses a significant public health concern. Research indicates that self-harm occurs in approximately 5% of adults, 17% of adolescents, and between 17% and 35% of college students in the U.S. (MHA, n.d.). […] NSSI exists in almost all cultures and ethnicities, but prevalence rates, contributing factors, functions, and methods of NSSI may be different across cultures and contexts. Although studies in non-Western countries are limited compared Western countries, lifetime prevalence rates of NSSI have been reported among young adults in China (23%), Belgium (8%), India (21%), Turkey (15-33%), Mexico (17-19%), and the U.S. (12-23%) (Gandhi et al., 2021; Mannekote Thippaiah et al., 2021).
#25
https://link.springer.com/article/10.1007/s00787-023-02264-y
The pooled estimate from Asian countries (19.5%) was significantly higher than that from other continents (14.6%). […] To our best knowledge, this is the most recent meta-analysis on the prevalence of SIB among adolescents. An overall prevalence of 16% was found, which means that one in six adolescents has a history of self-harm.
#26 Self-Harm Awareness Month – USCRI
https://refugees.org/self-harm-awareness-month/
Although research is limited, studies have indicated higher prevalence rates of NSSI among migrants and refugees compared to host country populations (Baralla et al., 2021). Post-resettlement factors have also been linked to a higher potential for self-harm, as well as suicidal behavior, among migrants and refugees.
#27 Nonsuicidal Self-Injury among U.S. Adolescents – Suicide Prevention Resource Center
https://sprc.org/news/nonsuicidal-self-injury-among-u-s-adolescents/
Native American youth appeared to be at higher risk for NSSI, with more than 20% reporting past-year NSSI, compared to 17.7% of White youth and 12.1% of Black youth. […] Researchers also found multiple health risk factors associated with NSSI, including experiences of online bullying, depression, and suicidal thoughts or plans in the past year, as well as use of cigarettes and other substances. […] This research identified youth who may be at higher risk for NSSI, including younger females, and those experiencing risk factors such as bullying, depression, suicidal thoughts or behaviors, and substance use.
#28 Excess Risk of Self-Injury Linked to Autism | Columbia University Mailman School of Public Health
https://www.publichealth.columbia.edu/news/excess-risk-self-injury-linked-autism
People with autism spectrum disorder (ASD) are at substantially increased risk of self-injury and suicide, according to a study by researchers at Columbia University Mailman School of Public Health and Columbia College of Physicians and Surgeons. They found that odds of self-harm in people with autism spectrum disorder were over three times that of people without ASD. […] The findings from our systematic review and meta-analysis underscore the need for targeted interventions to reduce the risk of self-harm in people with autism, said Ashley Blanchard, MD, MS, assistant professor of emergency medicine at the Vagelos College of Physicians and Surgeons. […] The researchers used PubMed, Embase, CINAHL, PsychInfo, Web of Science databases from 1999 through June of 2020 to identify studies on the relationship between ASD and self-injurious behavior and suicide.
#29 Excess Risk of Self-Injury Linked to Autism | Columbia University Mailman School of Public Health
https://www.publichealth.columbia.edu/news/excess-risk-self-injury-linked-autism
Twenty-nine showed statistically significant positive associations between ASD and self-harm, and that people with ASD were at similarly increased risk of self-injury behavior and suicide. […] The prevalence of self-injurious behavior, such as hand-hitting, self-cutting, and hair pulling, is as high as 42 percent in the autism population. […] Further research should aim to determine the impact of co-occurring diagnoses, develop injury surveillance systems for the autism population, and implement effective prevention strategies to ensure the safety and well-being of people with ASD.
#30 Nonsuicidal Self-Injury DSM-5
https://www.theravive.com/therapedia/nonsuicidal-self–injury-dsm–5
NSSI has a prevalence rate of about 1 to 4 percent in the adult population in the United States (Kerr, Muehlenkamp, Turner, 2010) Furthermore the extremely severe form of self-injury is seen in about 1 percent of the population (Kerr, Muehlenkamp, Turner, 2010). […] Though some research has indicated a lifetime prevalence of NSSI being as high as 5.9 percent and an increased 2.7 percent that have self injured greater than five times (Klonsky, 2011). […] NSSI is more common among teenagers, with a reported 15 percent admitting to some type of self-injury (Kerr, Muehlenkamp, Turner, 2010). […] Furthermore, there is a greater risk for NSSI among college students when compared to the general population, where rates range from 17 to 35 percent. […] Cutting is the most common form of NSSI, where as much as 70 percent of NSSI patients, state that they have used the cutting form in the past.
#31 Self-harm – Wikipedia
https://en.wikipedia.org/wiki/Self-harm
The onset of self-harm tends to occur around puberty, although scholarship is divided as to whether this is usually before puberty or later in adolescence. […] Meta-analyses have not supported some studies’ conclusion that self-harm rates are increasing among adolescents. […] The CASE (Child & Adolescent Self-harm in Europe) study suggests that the life-time risk of self-injury is ~1:7 for women and ~1:25 for men. […] Deliberate self-harm is common in the developing world. […] Research into self-harm in these areas is however, still very limited. […] Deliberate self-harm is especially prevalent in prison populations.
#32 Non-suicidal self-injury: The nurse practitionerâs role
https://www.npwomenshealthcare.com/non-suicidal-self-injury-nurse-practitioners-role-identification-treatment/
Non-suicidal self-injury (NSSI) is an increasingly common way in which adolescents and adults cope with emotional pain. […] The authors discuss the nature and prevalence of NSSI, risk factors and common signs and symptoms of NSSI, and available therapeutic interventions. […] Because of its increasing prevalence, NSSI has been added to the Diagnostic and Statistical Manual of Mental Health Disorders, Fifth Edition (DSM-5). […] Self-injurious behavior has been reported in 13%-25% of adolescents and young adults, with the behavior commonly beginning between the ages of 14 and 24. […] Some studies have suggested that young persons identifying as bisexual or questioning are at significantly elevated risk for self-injury compared with their heterosexual and homosexual peers; this finding is especially true for females.
#33 Non-suicidal self-injury: The nurse practitionerâs role
https://www.npwomenshealthcare.com/non-suicidal-self-injury-nurse-practitioners-role-identification-treatment/
Other studies have reported the following risk factors for NSSI: depression, depression in ones parents, anxiety, substance abuse, borderline personality disorder (BPD), post-traumatic stress disorder, self-identification as non-heterosexual, emotional or physiologic distress, and difficulty with interpersonal relationships. […] Engagement in NSSI among young persons may also be attributed, at least in part, to social contagion. […] Although often initiated in adolescence, NSSI is not limited to this age group, with a reported adult lifetime prevalence of approximately 6%. […] Adolescents and adults with mental illness are reported to have the highest incidence of NSSI. […] Recent research suggests that adolescents whose parents exhibited self-regulatory challenges such as substance use or attention deficit disorder were at increased risk for NSSI.
#34 Epidemiology and trends in non-fatal self-harm in three centres in England: 2000â2007 | The British Journal of Psychiatry | Cambridge Core
https://www.cambridge.org/core/journals/the-british-journal-of-psychiatry/article/epidemiology-and-trends-in-nonfatal-selfharm-in-three-centres-in-england-20002007/3325A1DCE4628DBCB7D2865919AAFDD0
Health service planning requires up-to-date information on trends in self-harm to maintain an optimal provision of services, and to assess the effectiveness of management and preventive policies. […] The aim of this study was to investigate trends in non-fatal self-harm in multiple centres between 2000 and 2007, and to relate these to trends in suicide. […] The decline in rates over the 8-year period was also greater in Manchester (21%) and Derby (15%) than Oxford (8%). […] The trends found in this study are in contrast to the steady increase in rates of self-harm found a decade earlier. […] Non-fatal self-harm leading to hospital attendance is the strongest risk factor for completed suicide, and these decreasing trends are consistent with the current downward trend in suicide rates in England over this period.
#35
https://link.springer.com/article/10.1007/s00787-023-02264-y
In the past 10 years, there has been a growing interest in self-injurious behavior (SIB) among adolescents. The lifetime prevalence of SIB is between 16 and 22% in community sample with females more likely to engage in SIB. […] The overall average prevalence of nonsuicidal self-injury in the studies was 16%. There was a significant gender difference: females reported a higher prevalence than males (19.4% and 12.9%, respectively). […] The current research draws attention to the high prevalence of SIB among adolescents, especially among females and those living in Asia. It is important to address this behavior, both in terms of prevention and intervention. […] Based on the previous meta-analyses, the prevalence of SIB shows a significant increase in the 1990s, but then a stagnation from 2005.
#36 Deliberate Self-Harm: Epidemiology and Risk Factors | Neupsy Key
https://neupsykey.com/deliberate-self-harm-epidemiology-and-risk-factors/
Deliberate self-harm (DSH) refers to behaviour through which people deliberately inflict acute harm upon themselves, poison themselves, or try do so, with non-fatal outcome. […] In the 1960s and 1970s, there was a sharp increase in the number of people treated in hospitals in Europe, the United States and Australia because of intentional overdoses or self-injury. […] In the early 1990s these numbers increased further in some regions. […] The absolute number of persons treated for deliberate self-harm in general hospitals, however, does not adequately reflect the size of the problem. […] Except for Ireland, where a National Registry of Deliberate Self-Harm has been established, there are no national registries that reliably monitor trends in DSH treated in general hospitals. […] Even though DSH is considered a major problem in the United States, clinical epidemiological research into DSH is uncommon.
#37 Epidemiology and trends in non-fatal self-harm in three centres in England, 2000â2012: findings from the Multicentre Study of Self-harm in England | BMJ Open
https://bmjopen.bmj.com/content/6/4/e010538
Self-harm is a major health problem in many countries, with potential adverse outcomes including suicide and other causes of premature death. It is important to monitor national trends in this behaviour. We examined trends in non-fatal self-harm and its management in England during the 13-year period, 20002012. […] During 20002012, there were 84378 self-harm episodes (58.6% by females), involving 47048 persons. […] Rates of self-harm declined in females (incidence rate ratio (IRR) 0.98; 95% CI 0.97 to 0.99, p0.0001). In males, rates of self-harm declined until 2008 (IRR 0.96; 95% CI 0.95 to 0.98, p0.0001) and then increased (IRR 1.05; 95% CI 1.02 to 1.09, p=0.002). […] A substantial increase in self-injury occurred in the latter part of the study period. This was especially marked for self-cutting/stabbing and hanging/asphyxiation.
#38 Epidemiology and trends in non-fatal self-harm in three centres in England: 2000â2007 | The British Journal of Psychiatry | Cambridge Core
https://www.cambridge.org/core/journals/the-british-journal-of-psychiatry/article/epidemiology-and-trends-in-nonfatal-selfharm-in-three-centres-in-england-20002007/3325A1DCE4628DBCB7D2865919AAFDD0
Self-harm is a common reason for presentation to a general hospital, with a strong association with suicide. Trends in self-harm are an important indicator of community psychopathology, with resource implications for health services and relevance to suicide prevention policy. […] Rates of self-harm declined significantly over 8 years for males in three centres (Oxford: 14%; Manchester: 25%; Derby: 18%) and females in two centres (Oxford: 2% (not significant); Manchester: 13%; Derby: 17%), in keeping with national trends in suicide. […] There were decreasing rates of non-fatal self-harm over the study period that paralleled trends in suicide in England. […] Non-fatal self-harm is an important public health problem in England. […] Self-harm is the main risk factor for completed suicide and is associated with increased all-cause mortality.
#39 Epidemiology and trends in non-fatal self-harm in three centres in England: 2000â2007 | The British Journal of Psychiatry | Cambridge Core
https://www.cambridge.org/core/journals/the-british-journal-of-psychiatry/article/epidemiology-and-trends-in-nonfatal-selfharm-in-three-centres-in-england-20002007/3325A1DCE4628DBCB7D2865919AAFDD0
Self-harm is a common reason for presentation to a general hospital, with a strong association with suicide. Trends in self-harm are an important indicator of community psychopathology, with resource implications for health services and relevance to suicide prevention policy. […] Rates of self-harm declined significantly over 8 years for males in three centres (Oxford: 14%; Manchester: 25%; Derby: 18%) and females in two centres (Oxford: 2% (not significant); Manchester: 13%; Derby: 17%), in keeping with national trends in suicide. […] There were decreasing rates of non-fatal self-harm over the study period that paralleled trends in suicide in England. […] Non-fatal self-harm is an important public health problem in England. […] Self-harm is the main risk factor for completed suicide and is associated with increased all-cause mortality.
#40 Epidemiology and trends in non-fatal self-harm in three centres in England, 2000â2012: findings from the Multicentre Study of Self-harm in England | BMJ Open
https://bmjopen.bmj.com/content/6/4/e010538
Self-harm is a major health problem in many countries, with potential adverse outcomes including suicide and other causes of premature death. It is important to monitor national trends in this behaviour. We examined trends in non-fatal self-harm and its management in England during the 13-year period, 20002012. […] During 20002012, there were 84378 self-harm episodes (58.6% by females), involving 47048 persons. […] Rates of self-harm declined in females (incidence rate ratio (IRR) 0.98; 95% CI 0.97 to 0.99, p0.0001). In males, rates of self-harm declined until 2008 (IRR 0.96; 95% CI 0.95 to 0.98, p0.0001) and then increased (IRR 1.05; 95% CI 1.02 to 1.09, p=0.002). […] A substantial increase in self-injury occurred in the latter part of the study period. This was especially marked for self-cutting/stabbing and hanging/asphyxiation.
#41 Epidemiology and trends in non-fatal self-harm in three centres in England, 2000â2012: findings from the Multicentre Study of Self-harm in England | BMJ Open
https://bmjopen.bmj.com/content/6/4/e010538
Trends in rates of self-harm and suicide may be closely related; therefore, self-harm can be a useful mental health indicator. […] Reliable and accurate data on self-harm are important for understanding national trends and risk factors for self-harm, planning appropriate health services and informing potentially effective preventive measures. […] The study only included individuals who presented to hospital following self-harm. […] The rates of self-harm reported in this study are based on urban populations; these have been shown to have higher rates of self-harm than rural populations. […] The monitoring systems in Oxford and Derby have approval from local Research Ethics Committees to collect data on self-harm for local and multicentre projects. […] The proportion of individuals receiving psychosocial assessment was greater in 2012 relative to 2003 (OR=1.35, 95% CI 1.26 to 1.44, p0.0001), although there was variation between the centres. […] There have been similar trends in rates of self-harm and suicide in England in recent years. Of note is the steady increase in self-harm observed since 2008, particularly in males, which coincided with the economic recession.
#42 Nonsuicidal Self-Injury DSM-5
https://www.theravive.com/therapedia/nonsuicidal-self–injury-dsm–5
NSSI has a prevalence rate of about 1 to 4 percent in the adult population in the United States (Kerr, Muehlenkamp, Turner, 2010) Furthermore the extremely severe form of self-injury is seen in about 1 percent of the population (Kerr, Muehlenkamp, Turner, 2010). […] Though some research has indicated a lifetime prevalence of NSSI being as high as 5.9 percent and an increased 2.7 percent that have self injured greater than five times (Klonsky, 2011). […] NSSI is more common among teenagers, with a reported 15 percent admitting to some type of self-injury (Kerr, Muehlenkamp, Turner, 2010). […] Furthermore, there is a greater risk for NSSI among college students when compared to the general population, where rates range from 17 to 35 percent. […] Cutting is the most common form of NSSI, where as much as 70 percent of NSSI patients, state that they have used the cutting form in the past.
#43 Self Harm Prevention – Wyoming Department of Health
https://health.wyo.gov/publichealth/prevention/wivpp/self-harm-awareness/
Self-harm is usually connected to high-levels of emotional distress that may happen because of: […] Wyoming hospitals reported that over 200 Wyomingites were hospitalized each year from 2016 to 2019 because of self-harm injuries. All together, more than 900 residents were hospitalized during that time. About every 9 out of 10 of these hospitalizations were reported to be because of an intentional drug overdose, also called a drug poisoning. Wyoming hospitals reported that adolescents age 15 to 19 were the most commonly admitted group because of self-harm injuries (15%, or 151 total) during 2016-2019. Hospitals also reported that over two-thirds of these teens hospitalized were female. In 2020 alone, hospitals around the US reported about 187,000 hospitalizations because of some method of self-harm. Globally, about 17% of all people are predicted to self-harm at some point in their life. Among teens, 17% are predicted to self-harm at least once. On average, cutting is reported to be the most common method of self-harm, and is found in almost half (45%) of all reports of self-harm around the world.
#44 Patterns of self-harm presentations at a Tertiary Urban Hospital in Kenya: A retrospective 5-year study (2018â2022) | PLOS One
https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0317981
The majority of reported self-harm cases involved overdose incidents (68.8%), with self-injury accounting for 56.3% of cases. […] In context of self-injury, cutting emerged as the predominant form of self-harm. […] This study shows a high rate of self-harm among patients with mental illness in this facility, necessitating the development of self-harm prevention and management protocols. […] A national registry of self-harm behavior would also help further elucidate the occurrence and mechanisms of self-harm in the population, improving the possibility for early interventions and prevention. […] Kenya is yet to establish a national suicide and self-harm surveillance system and therefore its estimates of this burden may not be reliable. […] This lack of data impedes the prioritization and planning of suicide prevention strategies.
#45 Self-Injury: Why Kids Cut Themselves & How to Help | Child Mind Institute
https://childmind.org/article/what-drives-self-injury-and-how-to-treat-it/
When a person develops a habit of cutting their arms it might look like suicidal behavior, but it actually isnât. People who self-injure arenât trying to kill themselves, they are trying to alleviate some emotional distress they are feeling. However, the behavior indicates a depth of psychic pain that could lead to a suicide attempt. The behavior is also inherently dangerous because people who self-injure may hurt themselves more seriously than intended or develop infections or other medical complications. […] Experts call it âself-injury,â and as many as a quarter of all teenagers do it. […] The most common form of self-injury is cutting or scratching the skin with anything that can draw blood, such as razors or even paperclips and pen caps, but people also self-injure by burning themselves, picking at skin and wounds, or hitting themselves. They often start around puberty.
#46 Self-Injury: Why Kids Cut Themselves & How to Help | Child Mind Institute
https://childmind.org/article/what-drives-self-injury-and-how-to-treat-it/
The impulse a teenager feels to harm themself is almost always triggered by a specific event in their life. The most common âtriggerâ for cutting is feeling rejected: by a romantic interest, by their close friends, or by a general feeling of being left out or criticized. […] If you discover that a child has been self-harming, even if they say it was a one-time thing, itâs important to get help. Itâs true that kids might experiment with self-injury, especially if they have friends who are doing it, but itâs a serious and dangerous behavior, and you donât want to ignore what might be a real mental health issue.
#47 Teens and Self-Cutting (Self-Harm): Information for Parents
https://pubs.nmsu.edu/_i/I104/index.html
According to the Mayo Clinic (2012), certain factors may increase the risk of self-cutting and self-injury. […] Females are at greater risk of self-cutting than males. […] Self-injury often starts in the early teen years. […] Being around people or friends who self-cut. […] Self-cutters often have poor coping skills and/or mental disorders (e.g., depression, anxiety, post-traumatic stress). […] Self-cutters often harm themselves while under the influence of alcohol or drugs.
#48 Teens and Self-Cutting (Self-Harm): Information for Parents
https://pubs.nmsu.edu/_i/I104/index.html
According to the Mayo Clinic (2012), certain factors may increase the risk of self-cutting and self-injury. […] Females are at greater risk of self-cutting than males. […] Self-injury often starts in the early teen years. […] Being around people or friends who self-cut. […] Self-cutters often have poor coping skills and/or mental disorders (e.g., depression, anxiety, post-traumatic stress). […] Self-cutters often harm themselves while under the influence of alcohol or drugs.
#49 New study finds self-harm may be socially contagious among adolescents | About us
https://www.uottawa.ca/about-us/media/news/new-study-finds-self-harm-may-be-socially-contagious-among-adolescents
A new study led by University of Ottawa epidemiologist Dr. Ian Colman suggests non-suicidal self-injury behaviours like cutting oneself without the intent to die may be contagious among teenagers, who are more likely to harm themselves when they know someone who has. […] Non-suicidal self-injury is much more common than suicide attempts – twice as common in this study – and many, many times more common than death by suicide, says Dr. Colman, an Associate Professor in the Faculty of Medicine and holder of the Canada Research Chair in Mental Health Epidemiology. […] Dr. Colman’s study builds on previous research showing teens who are exposed to suicide among their peers are more than twice as likely to demonstrate suicidal behaviour or harbour suicidal thoughts than those who are not exposed. This sort of communication of ideation and behaviour is a form of contagion, and its spread can be tracked by epidemiologists just as physically communicable diseases are studied.
#50 Teens and Self-Cutting (Self-Harm): Information for Parents
https://pubs.nmsu.edu/_i/I104/index.html
According to the Mayo Clinic (2012), certain factors may increase the risk of self-cutting and self-injury. […] Females are at greater risk of self-cutting than males. […] Self-injury often starts in the early teen years. […] Being around people or friends who self-cut. […] Self-cutters often have poor coping skills and/or mental disorders (e.g., depression, anxiety, post-traumatic stress). […] Self-cutters often harm themselves while under the influence of alcohol or drugs.
#51 Teens and Self-Cutting (Self-Harm): Information for Parents
https://pubs.nmsu.edu/_i/I104/index.html
According to the Mayo Clinic (2012), certain factors may increase the risk of self-cutting and self-injury. […] Females are at greater risk of self-cutting than males. […] Self-injury often starts in the early teen years. […] Being around people or friends who self-cut. […] Self-cutters often have poor coping skills and/or mental disorders (e.g., depression, anxiety, post-traumatic stress). […] Self-cutters often harm themselves while under the influence of alcohol or drugs.
#52 Non-suicidal self-injury: The nurse practitionerâs role
https://www.npwomenshealthcare.com/non-suicidal-self-injury-nurse-practitioners-role-identification-treatment/
Other studies have reported the following risk factors for NSSI: depression, depression in ones parents, anxiety, substance abuse, borderline personality disorder (BPD), post-traumatic stress disorder, self-identification as non-heterosexual, emotional or physiologic distress, and difficulty with interpersonal relationships. […] Engagement in NSSI among young persons may also be attributed, at least in part, to social contagion. […] Although often initiated in adolescence, NSSI is not limited to this age group, with a reported adult lifetime prevalence of approximately 6%. […] Adolescents and adults with mental illness are reported to have the highest incidence of NSSI. […] Recent research suggests that adolescents whose parents exhibited self-regulatory challenges such as substance use or attention deficit disorder were at increased risk for NSSI.
#53 Salivary beta-endorphin in nonsuicidal self-injury: an ambulatory assessment study | Neuropsychopharmacology
https://www.nature.com/articles/s41386-020-00914-2
Nonsuicidal self-injury (NSSI) is a prevalent and impairing behavior, affecting individuals with and without additional psychopathology. […] This is the first study assessing salivary -endorphin in daily life in the context of NSSI acts. […] We found that -endorphin levels immediately before an NSSI act were significantly lower than directly after NSSI. […] The results of the present study indicate that it is possible to assess salivary -endorphin in daily life in the context of NSSI. […] Furthermore, our results provide a first indication that NSSI acts could be associated with a momentary increase of -endorphin, and this might reinforce NSSI engagement. […] Nonsuicidal self-injury (NSSI) is defined as the intentional and deliberate damage of ones own body tissue without suicidal intent.
#54 Self-injury: Why teens do it, how to help
https://www.contemporarypediatrics.com/view/self-injury-why-teens-do-it-how-help
By definition, NSSI is self-injury carried out without the wish to die. In the moment, people who engage in this type of self-injury are not exhibiting suicidal behavior. On the contrary, they often use NSSI as a way to make being alive more bearable. Nevertheless, NSSI is a risk factor for later suicide attempts. […] Nonsuicidal self-injury that occurs more frequently and in more severe forms is also a strong predictor of suicidal behavior. In a clinical sample of depressed teenagers, NSSI predicted future suicide attempts just as strongly as past suicide attempts. This link between NSSI and suicide held up even when the reviewers controlled for demographic differences, psychosocial conditions, and comorbid psychopathologies. […] Self-injury is a sign that a teenager is both experiencing uncomfortable feelings and is ill equipped to manage them. Therefore, the general practitioner should ask about other dangerous behaviors that, like self-injury, tend to be used to cope with stress. Disordered eating, substance abuse, and risky sexual activity are all associated with self-injury and can have independent medical consequences that warrant evaluation.
#55 Self Harm Prevention – Wyoming Department of Health
https://health.wyo.gov/publichealth/prevention/wivpp/self-harm-awareness/
Studies have found that, on average, teens will start to self-harm at age 13. These studies have also found that teens will self-harm more frequently and often at age 16. If a teen self-harms, they are five-times more likely to experience thoughts of suicide, also known as suicidal ideation. Teens are also found to be ten-times more likely to attempt suicide if they self-harm. These risks are greater the more frequently a teen self-harms. Overall, almost 1 in 3 teens (30%) that self-harm have reported a suicide attempt.
#56 Self Harm Prevention – Wyoming Department of Health
https://health.wyo.gov/publichealth/prevention/wivpp/self-harm-awareness/
Studies have found that, on average, teens will start to self-harm at age 13. These studies have also found that teens will self-harm more frequently and often at age 16. If a teen self-harms, they are five-times more likely to experience thoughts of suicide, also known as suicidal ideation. Teens are also found to be ten-times more likely to attempt suicide if they self-harm. These risks are greater the more frequently a teen self-harms. Overall, almost 1 in 3 teens (30%) that self-harm have reported a suicide attempt.
#57 How Are Self-Injury and Suicide Related? – Child Mind Institute
https://childmind.org/article/how-are-self-injury-and-suicide-related/
The intent is different, though one can lead to the other […] Self-injury and suicidal behaviors â imagining, planning or attempting suicide â are related, but the relationship between the two is confusing. […] Because of these common risk factors, it is important for you to know that youth who self-injure are also at increased risk for suicidality. Our work shows that about 65 percent of youth who self-injure will also be suicidal at some point (though many will not go beyond having suicidal thoughts). […] Although self-injury does not cause suicide, the other important thing to know about the relationship between self-injury and suicide is that the very act of engaging in self-injury reduces inhibition to suicidal behavior if someone becomes suicidal. […] These risk factors may be present individually or in clusters. The more of these your child has, the higher their risk is of at least having suicidal thoughts (this is called âsuicidal ideationâ).
#58 How Are Self-Injury and Suicide Related? – Child Mind Institute
https://childmind.org/article/how-are-self-injury-and-suicide-related/
The intent is different, though one can lead to the other […] Self-injury and suicidal behaviors â imagining, planning or attempting suicide â are related, but the relationship between the two is confusing. […] Because of these common risk factors, it is important for you to know that youth who self-injure are also at increased risk for suicidality. Our work shows that about 65 percent of youth who self-injure will also be suicidal at some point (though many will not go beyond having suicidal thoughts). […] Although self-injury does not cause suicide, the other important thing to know about the relationship between self-injury and suicide is that the very act of engaging in self-injury reduces inhibition to suicidal behavior if someone becomes suicidal. […] These risk factors may be present individually or in clusters. The more of these your child has, the higher their risk is of at least having suicidal thoughts (this is called âsuicidal ideationâ).
#59 Characteristics of surveillance systems for suicide and self-harm: A scoping review | PLOS Global Public Health
https://journals.plos.org/globalpublichealth/article?id=10.1371/journal.pgph.0003292
Suicide is a complex public health issue. Surveillance systems play a vital role in identifying trends and epidemiologic needs, informing public health strategies, and tailoring effective context-based suicide prevention interventions. […] To effectively identify trends and at-risk populations, timely self-harm monitoring and registration are crucial. Improved data surveillance can facilitate the design of targeted interventions and strategies tailored to specific needs and contexts. […] Public health surveillance systems can be defined as tools that offer indispensable data regarding the prevalence, incidence, and features of health conditions. The data collected through surveillance systems play a vital role in helping government and healthcare sectors identify trends and epidemiologic needs, informing the development of public health strategies and suicide prevention interventions. […] This review identified the characteristics of surveillance systems for suicide and self-harm. Monitoring and evaluation are crucial for ongoing relevance and impact on prevention efforts.
#60 Self-harm injury hospitalisations: an analysis of case selection criteria | Injury Prevention
https://injuryprevention.bmj.com/content/27/Suppl_1/i49
Surveillance of self-inflicted injury is essential to understanding burden and changes over time. However, data on nonfatal self-harm are not systematically collected and reported at the national, state or local level. Surveillance for self-harm and injuries of all types is often conducted by monitoring ED visits and inpatient hospitalisations. Since the 1970s, administrative claims data from these settings have been coded using the International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM). In October 2015, the US Department of Health and Human Services mandated that all entities covered by the Health Insurance Portability and Accountability Act use the Tenth Revision (ICD-10-CM) when reporting medical care information. This transition to ICD-10-CM helped enhance data quality, support comparable morbidity and mortality data, and allow international comparisons. The transition resulted in significant changes. Thousands more injury diagnosis and external cause codes were added allowing for greater specificity including: exact cause of injury, specific type of anatomic/physiologic injury and encounter type (ie, initial, subsequent or sequelae). […]
#61 Deliberate Self-Harm: Epidemiology and Risk Factors | Neupsy Key
https://neupsykey.com/deliberate-self-harm-epidemiology-and-risk-factors/
Deliberate self-harm (DSH) refers to behaviour through which people deliberately inflict acute harm upon themselves, poison themselves, or try do so, with non-fatal outcome. […] In the 1960s and 1970s, there was a sharp increase in the number of people treated in hospitals in Europe, the United States and Australia because of intentional overdoses or self-injury. […] In the early 1990s these numbers increased further in some regions. […] The absolute number of persons treated for deliberate self-harm in general hospitals, however, does not adequately reflect the size of the problem. […] Except for Ireland, where a National Registry of Deliberate Self-Harm has been established, there are no national registries that reliably monitor trends in DSH treated in general hospitals. […] Even though DSH is considered a major problem in the United States, clinical epidemiological research into DSH is uncommon.
#62 Self-harm injury hospitalisations: an analysis of case selection criteria | Injury Prevention
https://injuryprevention.bmj.com/content/27/Suppl_1/i49
Surveillance of self-inflicted injury is essential to understanding burden and changes over time. However, data on nonfatal self-harm are not systematically collected and reported at the national, state or local level. Surveillance for self-harm and injuries of all types is often conducted by monitoring ED visits and inpatient hospitalisations. Since the 1970s, administrative claims data from these settings have been coded using the International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM). In October 2015, the US Department of Health and Human Services mandated that all entities covered by the Health Insurance Portability and Accountability Act use the Tenth Revision (ICD-10-CM) when reporting medical care information. This transition to ICD-10-CM helped enhance data quality, support comparable morbidity and mortality data, and allow international comparisons. The transition resulted in significant changes. Thousands more injury diagnosis and external cause codes were added allowing for greater specificity including: exact cause of injury, specific type of anatomic/physiologic injury and encounter type (ie, initial, subsequent or sequelae). […]
#63 Self-harm injury hospitalisations: an analysis of case selection criteria | Injury Prevention
https://injuryprevention.bmj.com/content/27/Suppl_1/i49
Surveillance of self-inflicted injury is essential to understanding burden and changes over time. However, data on nonfatal self-harm are not systematically collected and reported at the national, state or local level. Surveillance for self-harm and injuries of all types is often conducted by monitoring ED visits and inpatient hospitalisations. Since the 1970s, administrative claims data from these settings have been coded using the International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM). In October 2015, the US Department of Health and Human Services mandated that all entities covered by the Health Insurance Portability and Accountability Act use the Tenth Revision (ICD-10-CM) when reporting medical care information. This transition to ICD-10-CM helped enhance data quality, support comparable morbidity and mortality data, and allow international comparisons. The transition resulted in significant changes. Thousands more injury diagnosis and external cause codes were added allowing for greater specificity including: exact cause of injury, specific type of anatomic/physiologic injury and encounter type (ie, initial, subsequent or sequelae). […]
#64 Self-harm injury hospitalisations: an analysis of case selection criteria | Injury Prevention
https://injuryprevention.bmj.com/content/27/Suppl_1/i49
In 2019, the US Centers for Disease Control and Prevention (CDC) published recommendations for an injury hospitalisation case definition based on ICD-10-CM codes. These recommendations focused on the creation of an injury subset that included records indicating an initial encounter for active treatment of an injury as the principal diagnosis (ie, the condition chiefly responsible for admission). Once the injury subset has been created, all diagnoses and external cause of morbidity codes noting an initial encounter are reviewed and the case is categorised by intent and mechanism of injury. Identification of cases involving intentional self-harm requires review of both diagnosis and external cause codes as some causes are reflected in unique diagnoses codes (poisoning, asphyxiation and suicide attempt) while others are reflected in unique external cause codes (all other means of intentional self-harm, such as cutting or firearms). […]
#65 Self-harm – Wikipedia
https://en.wikipedia.org/wiki/Self-harm
It is difficult to gain an accurate picture of incidence and prevalence of self-harm. […] Recorded figures can be based on three sources: psychiatric samples, hospital admissions and general population surveys. […] A 2015 meta-analysis of reported self-harm among 600,000 adolescents found a lifetime prevalence of 11.4% for suicidal or non-suicidal self-harm (i.e. excluding self-poisoning) and 22.9% for non-suicidal self-injury (i.e. excluding suicidal acts), for an overall prevalence of 16.9%. […] The World Health Organization estimates that, as of 2010, 880,000 deaths occur as a result of self-harm (including suicides). […] About 10% of admissions to medical wards in the UK are as a result of self-harm, the majority of which are drug overdoses. […] However, studies based only on hospital admissions may hide the larger group of self-harmers who do not need or seek hospital treatment for their injuries, instead treating themselves.
#66 Epidemiology and trends in non-fatal self-harm in three centres in England, 2000â2012: findings from the Multicentre Study of Self-harm in England | BMJ Open
https://bmjopen.bmj.com/content/6/4/e010538
Trends in rates of self-harm and suicide may be closely related; therefore, self-harm can be a useful mental health indicator. […] Reliable and accurate data on self-harm are important for understanding national trends and risk factors for self-harm, planning appropriate health services and informing potentially effective preventive measures. […] The study only included individuals who presented to hospital following self-harm. […] The rates of self-harm reported in this study are based on urban populations; these have been shown to have higher rates of self-harm than rural populations. […] The monitoring systems in Oxford and Derby have approval from local Research Ethics Committees to collect data on self-harm for local and multicentre projects. […] The proportion of individuals receiving psychosocial assessment was greater in 2012 relative to 2003 (OR=1.35, 95% CI 1.26 to 1.44, p0.0001), although there was variation between the centres. […] There have been similar trends in rates of self-harm and suicide in England in recent years. Of note is the steady increase in self-harm observed since 2008, particularly in males, which coincided with the economic recession.
#67 An exploration of the genetic epidemiology of non-suicidal self-harm and suicide attempt | BMC Psychiatry | Full Text
https://bmcpsychiatry.biomedcentral.com/articles/10.1186/s12888-021-03216-z
Self-harm is a major public health concern. It is the strongest predictor of completed suicide and is particularly common among young people; a group in which rates of serious self-harm appear to be rising. […] The genetic epidemiology of suicide and self-harm remains poorly understood. […] Understanding the genetic basis of suicide is complicated by the broad spectrum of behaviours that fall under suicidal behaviour, which include self-harm with varying levels of suicidal intent as well as death by suicide. […] The existing observational evidence suggests that NSSH and SA share some risk factors, whilst others may be unique to one type of behaviour. […] This study uses data from the Avon Longitudinal Study of Parents and Children (ALSPAC) birth cohort to explore the genetic architecture and overlap of NSSH and SA, utilising individual-level genetic and phenotypic data to conduct genome-wide complex traits analysis and PRS prediction.
#68 Characteristics of surveillance systems for suicide and self-harm: A scoping review | PLOS Global Public Health
https://journals.plos.org/globalpublichealth/article?id=10.1371/journal.pgph.0003292
Suicide is a complex public health issue. Surveillance systems play a vital role in identifying trends and epidemiologic needs, informing public health strategies, and tailoring effective context-based suicide prevention interventions. […] To effectively identify trends and at-risk populations, timely self-harm monitoring and registration are crucial. Improved data surveillance can facilitate the design of targeted interventions and strategies tailored to specific needs and contexts. […] Public health surveillance systems can be defined as tools that offer indispensable data regarding the prevalence, incidence, and features of health conditions. The data collected through surveillance systems play a vital role in helping government and healthcare sectors identify trends and epidemiologic needs, informing the development of public health strategies and suicide prevention interventions. […] This review identified the characteristics of surveillance systems for suicide and self-harm. Monitoring and evaluation are crucial for ongoing relevance and impact on prevention efforts.
#69 Characteristics of surveillance systems for suicide and self-harm: A scoping review | PLOS Global Public Health
https://journals.plos.org/globalpublichealth/article?id=10.1371/journal.pgph.0003292
Suicide is a complex public health issue. Surveillance systems play a vital role in identifying trends and epidemiologic needs, informing public health strategies, and tailoring effective context-based suicide prevention interventions. […] To effectively identify trends and at-risk populations, timely self-harm monitoring and registration are crucial. Improved data surveillance can facilitate the design of targeted interventions and strategies tailored to specific needs and contexts. […] Public health surveillance systems can be defined as tools that offer indispensable data regarding the prevalence, incidence, and features of health conditions. The data collected through surveillance systems play a vital role in helping government and healthcare sectors identify trends and epidemiologic needs, informing the development of public health strategies and suicide prevention interventions. […] This review identified the characteristics of surveillance systems for suicide and self-harm. Monitoring and evaluation are crucial for ongoing relevance and impact on prevention efforts.
#70 Characteristics of surveillance systems for suicide and self-harm: A scoping review | PLOS Global Public Health
https://journals.plos.org/globalpublichealth/article?id=10.1371/journal.pgph.0003292
Suicide is a complex public health issue. Surveillance systems play a vital role in identifying trends and epidemiologic needs, informing public health strategies, and tailoring effective context-based suicide prevention interventions. […] To effectively identify trends and at-risk populations, timely self-harm monitoring and registration are crucial. Improved data surveillance can facilitate the design of targeted interventions and strategies tailored to specific needs and contexts. […] Public health surveillance systems can be defined as tools that offer indispensable data regarding the prevalence, incidence, and features of health conditions. The data collected through surveillance systems play a vital role in helping government and healthcare sectors identify trends and epidemiologic needs, informing the development of public health strategies and suicide prevention interventions. […] This review identified the characteristics of surveillance systems for suicide and self-harm. Monitoring and evaluation are crucial for ongoing relevance and impact on prevention efforts.
#71 Patterns of self-harm presentations at a Tertiary Urban Hospital in Kenya: A retrospective 5-year study (2018â2022) | PLOS One
https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0317981
To inform the development of a national self-harm and suicide registry, a pilot self-harm registry was established at Aga Khan University Hospital in Nairobi in 2023. […] Our findings indicate that while religious affiliation may not act as a protective factor against self-harm, it does offer protection against self-harm attempts. […] Our retrospective study, conducted at a tertiary care facility, yielded several significant findings pertaining to patients presenting with self-harm behaviors. The majority were younger females, single college students. Notably, there were high rates of repeated self-harm attempts and elevated levels of suicidal intent. Overdose was the most frequently reported method of self-harm, specifically involving analgesics and tricyclic antidepressants.
#72 Self-harm – Wikipedia
https://en.wikipedia.org/wiki/Self-harm
It is difficult to gain an accurate picture of incidence and prevalence of self-harm. […] Recorded figures can be based on three sources: psychiatric samples, hospital admissions and general population surveys. […] A 2015 meta-analysis of reported self-harm among 600,000 adolescents found a lifetime prevalence of 11.4% for suicidal or non-suicidal self-harm (i.e. excluding self-poisoning) and 22.9% for non-suicidal self-injury (i.e. excluding suicidal acts), for an overall prevalence of 16.9%. […] The World Health Organization estimates that, as of 2010, 880,000 deaths occur as a result of self-harm (including suicides). […] About 10% of admissions to medical wards in the UK are as a result of self-harm, the majority of which are drug overdoses. […] However, studies based only on hospital admissions may hide the larger group of self-harmers who do not need or seek hospital treatment for their injuries, instead treating themselves.
#73 Self-harm injury hospitalisations: an analysis of case selection criteria | Injury Prevention
https://injuryprevention.bmj.com/content/27/Suppl_1/i49
Self-inflicted violence, with or without suicidal intent, is a public health emergency. For over a decade, self-harm by poisoning has ranked among the top five leading causes of injury emergency department (ED) visits resulting in hospitalisation in the USA (all ages) and second among those aged 15-24. Self-harm by other means (cutting and other specified means) has ranked among the top 20 leading causes of death. Furthermore, self-harming behaviours have been increasing and are especially prevalent among youth. Studies have found that those who self-harm are more likely to repeat the behaviour and are at increased risk of suicide. The urgency of addressing this problem is evident as suicide is consistently a leading cause of death and the suicide rate in the USA has been increasing for nearly two decades (up 34% from 1999 to 2017). Wisconsin has experienced an even greater increase (40%) over this period. […]
#74 APHA: Online Program
https://apha.confex.com/apha/135am/webprogram/Paper158933.html
Over the one-year study period, there were 2,028 ED discharges for self-inflicted injury, representing 0.35% of all discharges. The annual rate was 66 per 100,000. 32% of all self-inflicted injury discharges were for cutting (21 per 100,000). Among those with cutting injuries, the mean age was 30 years, and most common among females ages 15-19 (81 per 100,000). Discharges ages 25-34 were more often male (31 per 100,000) than female (23 per 100,000). Whites had higher rates than Blacks or Hispanics (26, 21 and 15 per 100,000). 66% of injuries were to the elbow/forearm, and 76% produced an open versus superficial wound. 66% were diagnosed with a mental illness and 30% with alcohol use/abuse. 59% were sent home for self-care and 22% to a psychiatric hospital. […] ED discharges for self-inflicted cutting injuries are common and serious. The high prevalence of co-occurring mental illness and alcohol use/abuse support multidisciplinary intervention efforts.
#75 Teens and Self-Cutting (Self-Harm): Information for Parents
https://pubs.nmsu.edu/_i/I104/index.html
Self-cutting is associated with a range of psychiatric difficulties (Muehlenkamp et al., 2012) and is done primarily as a means to cope with painful emotions. […] Greydanus and Shek (2009) identified two pathways to self-cutting: Spring path Cutting may occur when there is a steady increase of tension until an upper limit or threshold is reached. […] NSSI may result from a teen’s efforts to resist thoughts of suicide, self-express anger or disgust, resolve feelings of detachment, influence others, or seek help from others (Greydanus and Shek, 2009). […] Greydanus and Shek found an association of drug abuse (including alcohol abuse) and eating disorders with DSH. […] Ross and Heath (2002) determined that adolescents who self-injured had higher measures for anxiety and depression than their peers who did not self-injure.
#76 APHA: Online Program
https://apha.confex.com/apha/135am/webprogram/Paper158933.html
Over the one-year study period, there were 2,028 ED discharges for self-inflicted injury, representing 0.35% of all discharges. The annual rate was 66 per 100,000. 32% of all self-inflicted injury discharges were for cutting (21 per 100,000). Among those with cutting injuries, the mean age was 30 years, and most common among females ages 15-19 (81 per 100,000). Discharges ages 25-34 were more often male (31 per 100,000) than female (23 per 100,000). Whites had higher rates than Blacks or Hispanics (26, 21 and 15 per 100,000). 66% of injuries were to the elbow/forearm, and 76% produced an open versus superficial wound. 66% were diagnosed with a mental illness and 30% with alcohol use/abuse. 59% were sent home for self-care and 22% to a psychiatric hospital. […] ED discharges for self-inflicted cutting injuries are common and serious. The high prevalence of co-occurring mental illness and alcohol use/abuse support multidisciplinary intervention efforts.
#77 Teens and Self-Cutting (Self-Harm): Information for Parents
https://pubs.nmsu.edu/_i/I104/index.html
Self-cutting is associated with a range of psychiatric difficulties (Muehlenkamp et al., 2012) and is done primarily as a means to cope with painful emotions. […] Greydanus and Shek (2009) identified two pathways to self-cutting: Spring path Cutting may occur when there is a steady increase of tension until an upper limit or threshold is reached. […] NSSI may result from a teen’s efforts to resist thoughts of suicide, self-express anger or disgust, resolve feelings of detachment, influence others, or seek help from others (Greydanus and Shek, 2009). […] Greydanus and Shek found an association of drug abuse (including alcohol abuse) and eating disorders with DSH. […] Ross and Heath (2002) determined that adolescents who self-injured had higher measures for anxiety and depression than their peers who did not self-injure.
#78 Teens and Self-Cutting (Self-Harm): Information for Parents
https://pubs.nmsu.edu/_i/I104/index.html
Self-cutting is associated with a range of psychiatric difficulties (Muehlenkamp et al., 2012) and is done primarily as a means to cope with painful emotions. […] Greydanus and Shek (2009) identified two pathways to self-cutting: Spring path Cutting may occur when there is a steady increase of tension until an upper limit or threshold is reached. […] NSSI may result from a teen’s efforts to resist thoughts of suicide, self-express anger or disgust, resolve feelings of detachment, influence others, or seek help from others (Greydanus and Shek, 2009). […] Greydanus and Shek found an association of drug abuse (including alcohol abuse) and eating disorders with DSH. […] Ross and Heath (2002) determined that adolescents who self-injured had higher measures for anxiety and depression than their peers who did not self-injure.
#79 Epidemiology and trends in non-fatal self-harm in three centres in England, 2000â2012: findings from the Multicentre Study of Self-harm in England | BMJ Open
https://bmjopen.bmj.com/content/6/4/e010538
Trends in rates of self-harm and suicide may be closely related; therefore, self-harm can be a useful mental health indicator. […] Reliable and accurate data on self-harm are important for understanding national trends and risk factors for self-harm, planning appropriate health services and informing potentially effective preventive measures. […] The study only included individuals who presented to hospital following self-harm. […] The rates of self-harm reported in this study are based on urban populations; these have been shown to have higher rates of self-harm than rural populations. […] The monitoring systems in Oxford and Derby have approval from local Research Ethics Committees to collect data on self-harm for local and multicentre projects. […] The proportion of individuals receiving psychosocial assessment was greater in 2012 relative to 2003 (OR=1.35, 95% CI 1.26 to 1.44, p0.0001), although there was variation between the centres. […] There have been similar trends in rates of self-harm and suicide in England in recent years. Of note is the steady increase in self-harm observed since 2008, particularly in males, which coincided with the economic recession.
#80 Epidemiology and trends in non-fatal self-harm in three centres in England: 2000â2007 | The British Journal of Psychiatry | Cambridge Core
https://www.cambridge.org/core/journals/the-british-journal-of-psychiatry/article/epidemiology-and-trends-in-nonfatal-selfharm-in-three-centres-in-england-20002007/3325A1DCE4628DBCB7D2865919AAFDD0
The decline in rates of self-harm in males in our study is consistent with this. […] Our findings suggest that prevention initiatives undertaken in England since the introduction of the national strategy in 2002, probably together with favourable societal factors, may have had a positive impact in reducing both self-harm and suicide.
#81 Health Agency Urges Parents, Caregivers to be Aware of Signs of Self-Harm After School Breaks | Wisconsin Department of Health Services
https://www.dhs.wisconsin.gov/news/releases/011724.htm
Data show increases in self-harm coincide with returning to school in September and January. Self-harming increased among youth by nearly 40% in September 2022 and January 2023 compared to each of the preceding months. While September 2023 showed a smaller spike in self-harming (14% increase from August 2023), it still represents a significant concern. Self-harm refers to intentional actions to hurt oneself. […] While someone who self-harms may not have the intention of suicide, they may be at greater risk of a suicide attempt or dying by suicide if they do not receive help. […] Self-harm reduction among adolescents 10-19 is a key focus area of DHS suicide prevention efforts funded through a grant from the U.S. Centers for Disease Control and Prevention (CDC).
#82 An exploration of the genetic epidemiology of non-suicidal self-harm and suicide attempt | BMC Psychiatry | Full Text
https://bmcpsychiatry.biomedcentral.com/articles/10.1186/s12888-021-03216-z
Self-harm is a major public health concern. It is the strongest predictor of completed suicide and is particularly common among young people; a group in which rates of serious self-harm appear to be rising. […] The genetic epidemiology of suicide and self-harm remains poorly understood. […] Understanding the genetic basis of suicide is complicated by the broad spectrum of behaviours that fall under suicidal behaviour, which include self-harm with varying levels of suicidal intent as well as death by suicide. […] The existing observational evidence suggests that NSSH and SA share some risk factors, whilst others may be unique to one type of behaviour. […] This study uses data from the Avon Longitudinal Study of Parents and Children (ALSPAC) birth cohort to explore the genetic architecture and overlap of NSSH and SA, utilising individual-level genetic and phenotypic data to conduct genome-wide complex traits analysis and PRS prediction.
#83 An exploration of the genetic epidemiology of non-suicidal self-harm and suicide attempt | BMC Psychiatry | Full Text
https://bmcpsychiatry.biomedcentral.com/articles/10.1186/s12888-021-03216-z
We conducted a GWAS of NSSH and SA in ALSPAC using snptest, adjusting for age, sex and population substructure by including the first ten principle components. […] Our findings suggest that the variance captured by SNPs is small, and there was a greater proportion of common genetic variation explained for NSSH than SA. […] Our findings suggest that SA does not have a large genetic component, and that although NSSH and SA are not discrete outcomes there appears to be little genetic overlap between the two.
#84 Self-harm – Wikipedia
https://en.wikipedia.org/wiki/Self-harm
The onset of self-harm tends to occur around puberty, although scholarship is divided as to whether this is usually before puberty or later in adolescence. […] Meta-analyses have not supported some studies’ conclusion that self-harm rates are increasing among adolescents. […] The CASE (Child & Adolescent Self-harm in Europe) study suggests that the life-time risk of self-injury is ~1:7 for women and ~1:25 for men. […] Deliberate self-harm is common in the developing world. […] Research into self-harm in these areas is however, still very limited. […] Deliberate self-harm is especially prevalent in prison populations.
#85 Non-suicidal Self-injury in the Over 40s: Results from a Large National Epidemiological Survey
https://www.omicsonline.org/open-access/nonsuicidal-selfinjury-in-the-over-40s-results-from-a-large-national-epidemiological-survey-2161-1165-1000266.php?aid=81052
While research on NSSI among older people is lacking, a substantial number of studies have investigated the broader construct of deliberate self-harm (DSH) in this population. […] The Australian National Epidemiological Study of Self-Injury (ANESSI) set out to map NSSI and its correlates across the life time, for the previous year and also for the past month, as well as implications for self-injurers, their families, mental health professionals and the Australian community. […] The focus of this paper is specifically on characteristics of older self-injurers (40 years), especially factors involved in initiation and perpetuation of NSSI. […] Given the international focus on NSSI in adolescents, and with only a handful of research studies referencing self-harm in older people, we believe it is important to have explored the group of over 40s from our large national community study. […] Despite limitations, we believe the research goes some way toward answering important questions about NSSI among older adults not explored elsewhere, and alerts us to the potential seriousness of self-injury in the over 40s population.
#86 Excess Risk of Self-Injury Linked to Autism | Columbia University Mailman School of Public Health
https://www.publichealth.columbia.edu/news/excess-risk-self-injury-linked-autism
Twenty-nine showed statistically significant positive associations between ASD and self-harm, and that people with ASD were at similarly increased risk of self-injury behavior and suicide. […] The prevalence of self-injurious behavior, such as hand-hitting, self-cutting, and hair pulling, is as high as 42 percent in the autism population. […] Further research should aim to determine the impact of co-occurring diagnoses, develop injury surveillance systems for the autism population, and implement effective prevention strategies to ensure the safety and well-being of people with ASD.