Institute for Maternal and Child Health - IRCCS "Burlo Garofolo", Trieste, Italy.
Child and Adolescent Neuropsychiatry Service, Azienda Sanitaria Universitaria Friuli Centrale, Udine, Italy.
Ital J Pediatr. 2021 Jan 22;47(1):14. doi: 10.1186/s13052-021-00958-0.
Suicide attempts and self-harm in adolescence are a major public health concern: they are among the main causes of disability-adjusted life-years worldwide, with severe long-term health consequences in terms of mental illness and psychiatric hospitalisation and a significantly increased risk of suicide. Several studies recently focused on the hypothesis that adolescents may be particularly vulnerable to emotional dysregulation and on the relation between problems with emotion regulation and suicidal and self-harming behaviours. Italian epidemiological data about prevalence of these behaviours at the community level are lacking. Our study aimed to estimate the prevalence of self-injurious thoughts and behaviours (SITBs) in a representative sample of community adolescents, and to examine the association between SITBs and the emotional and behavioural profiles.
Anonymous self-report questionnaires were completed by 1507 students aged 11-18 years from 24 high schools in the North-eastern Italian region of Friuli Venezia Giulia. Information was collected on SITBs, on the socio-environmental context, and on the psychological profile ('Achenbach's YSR questionnaire 11-18, Multidimensional Test of Self-harm and Multi-Attitude Suicide Tendency Scale).
Overall, 11.1% of adolescents reported self-harming behaviours without suicide ideation or attempts, 6.4% declared having thought to suicide without acting a suicide attempt or self-harm, 1.4% declared having attempted suicide and really thought to take away their life. Access to health services following a suicide thought, a self-harming behaviour or suicide attempt was infrequent, particularly for suicide ideation. At the YSR, all the SITBs groups reported high scores in almost all scales, with the most evident differences in the self-harming groups in which adolescents reported significantly higher scores in all scales, both internalising and externalising. An emotion dysregulation profile was found in almost all the groups.
This study provides us with an estimate of the prevalence of SITBs in the adolescent population and confirms the importance of further investigating the association between SITBs and emotion dysregulation. The naturalistic setting of community studies appears to be useful for studies in this field, and it allows to approach the onerous and often neglected issue of adolescent suicidality.
青少年时期的自杀企图和自残是一个主要的公共卫生问题：它们是全球残疾调整生命年的主要原因之一，对精神疾病和精神病院住院治疗有严重的长期健康后果，自杀风险显著增加。最近有几项研究集中在青少年可能特别容易出现情绪失调的假设上，以及情绪调节问题与自杀和自残行为之间的关系上。意大利关于社区一级这些行为流行率的流行病学数据缺乏。我们的研究旨在估计代表性社区青少年群体中自伤思想和行为（SITBs）的流行率，并研究 SITBs 与情绪和行为特征之间的关系。
来自意大利东北部弗留利-威尼斯朱利亚地区 24 所高中的 1507 名 11-18 岁学生匿名填写了自我报告问卷。收集了 SITBs、社会环境以及心理特征（Achenbach 的 YSR 问卷 11-18、多维自伤测试和多态度自杀倾向量表）的信息。
总体而言，11.1%的青少年报告有自残行为而没有自杀意念或企图，6.4%的青少年报告有自杀意念而没有实施自杀企图或自残，1.4%的青少年报告有自杀企图并且真的想结束自己的生命。在自杀意念、自残行为或自杀企图后，很少有人能获得医疗服务，特别是对于自杀意念。在 YSR 中，所有 SITBs 组在几乎所有量表中都报告了高分，在自残组中差异最为明显，这些青少年在所有量表上，包括内化和外化，报告的分数都明显更高。几乎所有的组都存在情绪失调的特征。
本研究提供了青少年人群中 SITBs 的流行率估计值，并证实了进一步研究 SITBs 与情绪失调之间关系的重要性。社区研究的自然环境似乎对这一领域的研究有用，并能解决青少年自杀这一棘手且往往被忽视的问题。
