Horváth Lili Olga, Mészáros Gergely, Balázs Judit
Eotvos Lorand Tudomanyegyetem Pszichologiai Doktori Iskola, Budapest, Hungary, E-mail:
Psychiatr Hung. 2020;35(4):476-483.
The fifth edition of the Diagnostic and Statistical Manual of Mental Disorders has included nonsuicidal self-injury (NSSI) as a proposed independent diagnostic category, emphasizing the nonsuicidal nature of the phenomenon. Nevertheless, this terminology and concept have provoked a still ongoing scientific debate among researchers and clinicians.
By extending a systematic search with a broader focus on the prevalence and psychopathological correlates of NSSI, the aim of the present study is to explore the relationships between NSSI and suicidal behavior.
A systematic literature search was conducted in five databases (PubMed, OVID Medline, OVID PsycINFO, Scopus, Web of Science) with the search terms "NSSI" and "prevalence" and "mental disorder" or "psychiatric disorder". The results were completed by manual searches. Inclusion criteria were for each publication to be an empirical study in English language that does not focus on a specific population.
A total of 25 papers examined the relationship between NSSI and suicidality explicitly. Among these papers, fifteen focused on children/adolescents, five on young adults, four on adults, and one on participants from heteroge - neous age groups. According to the results reviewed, altogether 50-70% of those who engaged in NSSI also reported suicidal thoughts or attempts. Those who did not report suicidal ideation differed from those who reported both NSSI and suicidal ideation in certain intra- and interpersonal traits (e.g., less depressive and borderline personality disor der symptoms, fewer negative life events, more social support) and in some specific characteristics (e.g., higher frequency and higher number methods) of NSSI.
Based on the publications reviewed, significant suicidal risk is associated with NSSI in both adolescence and adulthood. This risk may be even higher in the presence of certain comorbid disorders and other psychosocial factors as well as in the presence of certain NSSI patterns such as repetitiveness or multiple NSSI methods.
《精神疾病诊断与统计手册》第五版已将非自杀性自伤（NSSI）列为一个拟议的独立诊断类别，强调该现象的非自杀性质。然而，这一术语和概念在研究人员和临床医生中引发了仍在进行的科学辩论。
通过扩大系统检索，更广泛地关注NSSI的患病率及其心理病理学相关因素，本研究旨在探讨NSSI与自杀行为之间的关系。
在五个数据库（PubMed、OVID Medline、OVID PsycINFO、Scopus、Web of Science）中进行系统文献检索，检索词为“NSSI”、“患病率”以及“精神障碍”或“精神疾病”。通过手工检索完善结果。纳入标准为每篇出版物是一篇用英语撰写的实证研究，且不聚焦于特定人群。
共有25篇论文明确研究了NSSI与自杀倾向之间的关系。在这些论文中，15篇聚焦于儿童/青少年，5篇聚焦于青年，4篇聚焦于成年人，1篇聚焦于不同年龄组的参与者。根据所综述的结果，参与NSSI的人群中，总计有50%-70%的人还报告有自杀想法或自杀未遂。未报告自杀意念的人与报告有NSSI和自杀意念的人在某些个体内和人际特质（如抑郁和边缘型人格障碍症状较少、负面生活事件较少、社会支持较多）以及NSSI的一些特定特征（如更高的频率和更多的方法）方面存在差异。
基于所综述的出版物，在青少年和成年期，NSSI均与显著的自杀风险相关。在存在某些共病障碍和其他心理社会因素以及存在某些NSSI模式（如重复性或多种NSSI方法）的情况下，这种风险可能更高。
