Department of Maternal, Child and Adolescent Health, School of Public Health, Lanzhou University, Lanzhou, China.
Research Center for Psychological and Health Sciences, China University of Geosciences, Wuhan, China; Department of Psychiatric Rehabilitation, Shenzhen Kangning Hospital, Shenzhen, China.
J Affect Disord. 2022 Feb 1;298(Pt A):301-307. doi: 10.1016/j.jad.2021.10.130. Epub 2021 Oct 31.
Identifying the risk factors of suicide attempts(SA) in adolescents with mood disorders(MD) who engage in non-suicidal self-injury(NSSI) is of great significance for suicide prevention. The aim of the present study was to explore the psychological characteristics and risk factors of SA among MD adolescents engaged in NSSI.
We recruited MD outpatients accompany with NSSI aged 12-18 years. SA, NSSI methods and function, suicidal ideation(SI), psychological distress(PD), self-esteem, stress mindset and perceived social support were assessed by valid scales. Classification and regression tree analysis (CART) was employed to explore the characteristics and risk factors of SA among MD adolescent with NSSI.
We included 658 participants in this study. Of 58.1% participants reported SA during the past 12 months. Compared with the adolescents without SA, the attempters used more different NSSI methods and reported more frequent NSSI. SA, SI, PD, self-esteem and amount of thinking time before engaging in self-injury were risk factors of SA among MD adolescents. Interactions between the four risk factors resulted in varying degrees of risk of SA. Compared to adolescents with the characteristics of low level of SI - little consideration before self-injury, adolescents who having multiple characteristics of the high level of SI -high level of PD - low self-esteem were associated with a 15.1-fold increased risk of SA(P < 0.001), and those with the characteristics of high SI - deliberated before engaging in self-injury were associated with a 28.1-fold increased risk of attempted suicide(P < 0.001).
Our findings identify multiple correlates for SA in MD adolescents accompany with NSSI, including SI, PD, self-esteem and deliberate time they thought before self-injury, which may contribute to the development of suicidal behaviors in an interactive manner.
识别有非自杀性自伤（NSSI）行为的心境障碍（MD）青少年自杀未遂（SA）的风险因素对于预防自杀至关重要。本研究旨在探讨有 NSSI 行为的 MD 青少年 SA 的心理特征和风险因素。
我们招募了 12-18 岁伴有 NSSI 的 MD 门诊患者。采用有效的量表评估 SA、NSSI 方法和功能、自杀意念（SI）、心理困扰（PD）、自尊、压力思维和感知社会支持。采用分类回归树分析（CART）探讨有 NSSI 行为的 MD 青少年 SA 的特征和风险因素。
本研究共纳入 658 名参与者。58.1%的参与者报告在过去 12 个月内有过 SA。与无 SA 的青少年相比，有 SA 的青少年使用了更多不同的 NSSI 方法，且 NSSI 更频繁。SA、SI、PD、自尊和开始自伤前的思考时间是 MD 青少年发生 SA 的风险因素。四个风险因素之间的相互作用导致了不同程度的 SA 风险。与 SI 水平低-自伤前考虑少的青少年相比，具有 SI 水平高-PD 水平高-自尊低的多种特征的青少年发生 SA 的风险增加了 15.1 倍（P<0.001），具有 SI 水平高-在开始自伤前深思熟虑的特征的青少年发生自杀未遂的风险增加了 28.1 倍（P<0.001）。
我们的研究结果确定了有 NSSI 行为的 MD 青少年发生 SA 的多个相关因素，包括 SI、PD、自尊和开始自伤前的思考时间，这些因素可能以相互作用的方式导致自杀行为的发展。
