Wan Yu-Hui, Xu Shao-Jun, Chen Jing, Hu Chuan-Lai, Tao Fang-Biao
Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, 230032, Anhui, China.
Soc Psychiatry Psychiatr Epidemiol. 2015 Feb;50(2):237-47. doi: 10.1007/s00127-014-0917-x. Epub 2014 Jun 29.
Few longitudinal studies have examined the psychological symptoms that may lead to non-suicidal self-injury (NSSI) among Chinese adolescents and young adults. This study determined the predictive effects of psychological symptoms for NSSI during a 9-month follow-up period.
Data from 17,622 students, 12-24 years of age, were analyzed in a cross-sectional fashion with respect to associations between psychological symptoms and NSSI. Follow-up surveys were performed 3, 6, and 9 months later. Incident cases of NSSI during follow-up were correlated with the psychological symptoms at baseline.
A total of 3,001 (17.0%) students reported that they had NSSI in the 12 months before the initial assessment. The total rate of NSSI revealed no statistically significant differences by gender, but marked differences between grades. The response rate 3, 6, and 9 months later was 91.8, 81.8, and 79.1%, respectively. Our cross-sectional study demonstrated statistically significant associations between emotional problems, conduct problems, social adaptation problems, psychological problems, and NSSI (P < 0.01). In the longitudinal study, emotional problems, conduct problems, social adaptation problems, and psychological problems at baseline had statistically significant associations with incident NSSI in follow-up involving the adolescents, while the association in young adults was attenuated after adjustment for confounding variables. Moreover, psychological symptoms at baseline showed a monotonic dose-response relationship with NSSI in follow-up involving adolescents.
The findings suggest that adolescents with psychological symptoms are a group with elevated risks for later NSSI. The prevention programs of NSSI should target attenuating the severity of psychological symptoms.
很少有纵向研究调查过中国青少年和青年中可能导致非自杀性自伤（NSSI）的心理症状。本研究确定了心理症状在9个月随访期内对NSSI的预测作用。
对17622名年龄在12至24岁的学生的数据进行横断面分析，以研究心理症状与NSSI之间的关联。在3个月、6个月和9个月后进行随访调查。随访期间NSSI的新发病例与基线时的心理症状相关。
共有3001名（17.0%）学生报告在初次评估前的12个月内有过NSSI。NSSI的总发生率在性别上无统计学显著差异，但在年级间存在显著差异。3个月、6个月和9个月后的应答率分别为91.8%、81.8%和79.1%。我们的横断面研究表明，情绪问题、行为问题、社会适应问题、心理问题与NSSI之间存在统计学显著关联（P < 0.01）。在纵向研究中，基线时的情绪问题、行为问题、社会适应问题和心理问题与青少年随访期间的NSSI新发病例有统计学显著关联，而在青年中，调整混杂变量后这种关联减弱。此外，在青少年随访中，基线时的心理症状与NSSI呈单调剂量反应关系。
研究结果表明，有心理症状的青少年是后期发生NSSI风险较高的群体。NSSI的预防项目应旨在减轻心理症状的严重程度。
