Meszaros Gergely, Horvath Lili Olga, Balazs Judit
Semmelweis University, Mental Health Sciences School Of Ph.D., Üllői út 26, Budapest, 1085, Hungary.
Vadaskert Child Psychiatry Hospital and Outpatient Clinic, Lipótmezei út 1-5, Budapest, 1021, Hungary.
BMC Psychiatry. 2017 May 3;17(1):160. doi: 10.1186/s12888-017-1326-y.
During the last decade there is a growing scientific interest in nonsuicidal self-injury (NSSI). The aim of the current paper was to review systematically the literature with a special focus on the associations between self-injurious behaviours and externalizing psychopathology. An additional aim was to review terminology and measurements of self-injurious behaviour and the connection between self-injurious behaviours and suicide in the included publications.
A systematic literature search was conducted on 31st December 2016 in five databases (PubMed, OVID Medline, OVID PsycINFO, Scopus, Web of Science) with two categories of search terms (1. nonsuicidal self-injury, non-suicidal self-injury, NSSI, self-injurious behaviour, SIB, deliberate self-harm, DSH, self-injury; 2. externalizing disorder, attention deficit hyperactivity disorder, ADHD, conduct disorder, CD, oppositional defiant disorder, OD, ODD).
Finally 35 papers were included. Eleven different terms were found for describing self-injurious behaviours and 20 methods for measuring it. NSSI has the clearest definition. All the examined externalizing psychopathologies had strong associations with self-injurious behaviours according to: higher prevalence rates in externalizing groups than in control groups, higher externalizing scores on the externalizing scales of questionnaires, higher symptom severity in self-injurious groups. Eight studies investigated the relationship between suicide and self-injurious behaviours and found high overlap between the two phenomena and similar risk factors.
Based on the current findings the association between externalizing psychopathology and self-injurious behaviours has been proven by the scientific literature. Similarly to other reviews on self-injurious behaviours the confusion in terminology and methodology was noticed. NSSI is suggested for use as a distinct term. Further studies should investigate the role of comorbid conditions in NSSI, especially when internalizing and externalizing pathologies are both presented.
在过去十年中，科学界对非自杀性自伤行为（NSSI）的兴趣与日俱增。本文的目的是系统回顾相关文献，特别关注自伤行为与外化性精神病理学之间的关联。另一个目的是回顾自伤行为的术语和测量方法，以及纳入文献中自伤行为与自杀之间的联系。
2016年12月31日，在五个数据库（PubMed、OVID Medline、OVID PsycINFO、Scopus、Web of Science）中进行了系统的文献检索，使用了两类检索词：（1. 非自杀性自伤、非自杀性自我伤害、NSSI、自伤行为、SIB、蓄意自伤、DSH、自我伤害；2. 外化性障碍、注意力缺陷多动障碍、ADHD、品行障碍、CD、对立违抗障碍、OD、ODD）。
最终纳入35篇论文。发现有11个不同的术语用于描述自伤行为，以及20种测量方法。NSSI的定义最为清晰。根据以下方面，所有研究的外化性精神病理学与自伤行为都有很强的关联：外化性组的患病率高于对照组，问卷外化量表上的外化得分更高，自伤组的症状严重程度更高。八项研究调查了自杀与自伤行为之间的关系，发现这两种现象有高度重叠且风险因素相似。
基于目前的研究结果，科学文献已证实外化性精神病理学与自伤行为之间存在关联。与其他关于自伤行为的综述类似，注意到术语和方法存在混淆。建议使用NSSI作为一个明确的术语。进一步的研究应调查共病情况在NSSI中的作用问题，特别是当内化性和外化性病理同时出现时。
