Division of Psychiatry, Kennedy Tower, Royal Edinburgh Hospital, University of Edinburgh, Edinburgh, EH10 5HF, UK.
Centre for Genomic and Experimental Medicine, Institute of Genetics and Molecular Medicine, Western General Hospital, University of Edinburgh, Edinburgh, UK.
Soc Psychiatry Psychiatr Epidemiol. 2019 Dec;54(12):1505-1518. doi: 10.1007/s00127-019-01725-7. Epub 2019 May 23.
Self-harm is common, debilitating and associated with completed suicide and increased all-cause mortality, but there is uncertainty about its causal risk factors, limiting risk assessment and effective management. Neuroticism is a stable personality trait associated with self-harm and suicidal ideation, and correlated with coping styles, but its value as an independent predictor of these outcomes is disputed.
Prior history of hospital-treated self-harm was obtained by record-linkage to administrative health data in Generation Scotland:Scottish Family Health Study (N = 15,798; self-harm cases = 339) and by a self-report variable in UK Biobank (N = 35,227; self-harm cases = 772). Neuroticism in both cohorts was measured using the Eysenck Personality Questionnaire-Short Form. Associations of neuroticism with self-harm were tested using multivariable regression following adjustment for age, sex, cognitive ability, educational attainment, socioeconomic deprivation, and relationship status. A subset of GS:SFHS was followed-up with suicidal ideation elicited by self-report (n = 3342, suicidal ideation cases = 158) and coping styles measured by the Coping Inventory for Stressful Situations. The relationship of neuroticism to suicidal ideation, and the role of coping style, was then investigated using multivariable logistic regression.
Neuroticism was positively associated with hospital-associated self-harm in GS:SFHS (per EPQ-SF unit odds ratio 1.2 95% credible interval 1.1-1.2, p 0.0003) and UKB (per EPQ-SF unit odds ratio 1.1 95% confidence interval 1.1-1.2, p 9.8 × 10). Neuroticism, and the neuroticism-correlated coping style, emotion-oriented coping (EoC), were also associated with suicidal ideation in multivariable models.
Neuroticism is an independent predictor of hospital-treated self-harm risk. Neuroticism and emotion-orientated coping styles are also predictive of suicidal ideation.
自残行为很常见，会使人衰弱，并与自杀和全因死亡率增加有关，但对其因果危险因素仍存在不确定性，限制了风险评估和有效管理。神经质是一种与自残和自杀意念相关的稳定人格特质，与应对方式相关，但作为这些结果的独立预测因素的价值存在争议。
通过与苏格兰世代研究-苏格兰家庭健康研究（n=15798；自残病例=339）的行政健康数据记录链接和英国生物库中的自我报告变量（n=35227；自残病例=772）获得既往住院治疗的自残史。在两个队列中，使用艾森克人格问卷短式量表测量神经质。在调整年龄、性别、认知能力、教育程度、社会经济贫困和关系状况后，使用多变量回归测试神经质与自残之间的关联。GS：SFHS 的一个子集通过自我报告引出自杀意念（n=3342，自杀意念病例=158）并通过应激状况应对量表测量应对方式进行随访。然后，使用多变量逻辑回归研究神经质与自杀意念的关系，以及应对方式的作用。
神经质与 GS：SFHS 中的医院相关自残呈正相关（每 EPQ-SF 单位优势比 1.2，95%置信区间 1.1-1.2，p<0.0003）和 UKB（每 EPQ-SF 单位优势比 1.1，95%置信区间 1.1-1.2，p=9.8×10）。在多变量模型中，神经质和神经质相关的应对方式，即情绪导向应对（EoC），也与自杀意念相关。
神经质是医院治疗的自残风险的独立预测因素。神经质和情绪导向应对方式也可预测自杀意念。
