Martiniuk Alexandra L C, Chen Huei-Yang, Glozier Nick, Patton George, Senserrick Teresa, Williamson Ann, Woodward Mark, Ivers Rebecca
a The George Institute for Global Health , Australia .
Am J Drug Alcohol Abuse. 2015;41(5):465-73. doi: 10.3109/00952990.2015.1062023.
Deliberate self-harm (DSH) is reported by between 5 and 17% of youth aged 14-25 years. Current management measures focus on repetition prevention in high-risk groups.
To examine risk factors and predictors of DSH and DSH repetition in a community sample, by gender.
A prospective cohort of 20,822 young adults (aged 17-24 years) was recruited when obtaining their driving license. A random sample of 5000 was approached for follow-up 12-18 months; 2991 (60%) responded and formed the cohort for this analysis. Patterns of self-harm, using a modified Beck Suicide Inventory, were investigated with logistic regression.
DSH was reported by 4.1% (123/2991) at baseline. Over the following 12 months, 3.0% (90/2991) reported new instances of DSH which included 20% (25) respondents who had engaged in DSH at baseline. Psychological distress was a risk factor for engaging in DSH in the past 12 months, OR 3.55 (95% CI 2.06-6.14). Although several clinical risk factors differed between genders, high alcohol use, OR 23.6 (95% CI 3.64-153) and psychological distress, OR 4.97 (95% CI 1.08-22.9) were significant risk factors for repeat DSH in both males and females.
In this community cohort, 1 in 25 youth had self-harmed in the year prior; of these, 4 in 5 did not repeat DSH over the following year. High alcohol use stands out as a strong risk factor for DSH repetition. Assessing alcohol use may help clinicians identify those who are at greatest risk for repetitive self-harm.
据报告，14至25岁的青少年中有5%至17%曾故意自我伤害（DSH）。目前的管理措施侧重于预防高危人群中的重复行为。
按性别研究社区样本中DSH及DSH重复行为的风险因素和预测因素。
在年轻人取得驾照时招募了一个由20822名年轻人（年龄在17至24岁之间）组成的前瞻性队列。随机抽取5000人进行12至18个月的随访；2991人（60%）做出回应并形成了本分析的队列。使用改良的贝克自杀量表对自我伤害模式进行了逻辑回归研究。
基线时报告有DSH的比例为4.1%（123/2991）。在接下来的12个月里，3.0%（90/2991）报告有新的DSH情况，其中包括20%（25）在基线时就有DSH行为的受访者。心理困扰是过去12个月内发生DSH的一个风险因素，比值比为3.55（95%置信区间2.06至6.14）。尽管几种临床风险因素在性别之间存在差异，但高酒精摄入量，比值比为23.6（95%置信区间3.64至153）和心理困扰，比值比为4.97（95%置信区间1.08至22.9）是男性和女性重复DSH行为的显著风险因素。
在这个社区队列中，每25名青少年中有1人在之前一年曾有过自我伤害行为；在这些人中，五分之四在接下来的一年中没有重复DSH行为。高酒精摄入量是DSH重复行为的一个突出风险因素。评估酒精摄入量可能有助于临床医生识别那些重复自我伤害风险最高的人。
