非自杀性自伤与自杀未遂共现的荟萃分析：对临床干预和未来诊断的启示
A meta-analysis of co-occurrence of non-suicidal self-injury and suicide attempt: Implications for clinical intervention and future diagnosis.
作者信息
Ye Zhiyu, Xiong Fang, Li Wentian
机构信息
School of Education Research, China University of Geosciences, Wuhan, China.
Research Center for Psychological and Health Sciences, China University of Geosciences, Wuhan, China.
出版信息
Front Psychiatry. 2022 Aug 12;13:976217. doi: 10.3389/fpsyt.2022.976217. eCollection 2022.
BACKGROUND
Non-suicidal self-injury (NSSI) and suicide attempt (SA) are risk behaviors that lead to physical injury and even death in individuals, and are a very powerful risk factor when both occur together, with individuals presenting with more severe psychological and behavioral problems. Due to the different demographic characteristics of different study subjects, an overall understanding of the incidence and occurrence of this co-occurrence is lacking to clarify the focus of clinical interventions and future research directions.
METHODS
A systematic search was conducted for relevant studies in English and Chinese that reported data on co-occurring non-suicidal self-injury and suicide attempts as of May 2022. The incidence of co-occurrence of non-suicidal self-injury and suicide attempt (NSSI + SA) was calculated using Stata version 16.0 software based on a random-effects model, and the differences in incidence in different populations were compared by subgroups of age group, comorbidity, and time of occurrence. The study was written in strict accordance with PRISMA norms and registration was completed on the PROSPERO platform (CRD42022329095).
RESULTS
A total of 37 studies (139,573 individuals) were included for meta-analysis, and the combined incidence of non-suicidal self-injury and suicide attempt co-occurrence was 9.6%. Among different groups, the prevalence of NSSI + SA was 10, 11, 6, and 26% in adolescents and young adults, adults, the general population, and people with mental illness, respectively, and the co-occurrence of NSSI + SA within 12 months was 17%.
CONCLUSION
There is a significant group with a history of both non-suicidal self-injury and suicide attempts and presenting with more severe symptoms clinically. Targeted prevention and intervention are urgently needed, but the direction of intervention needs further research on the occurrence trajectory of this co-occurrence.
SYSTEMATIC REVIEW REGISTRATION
http://www.crd.york.ac.uk/PROSPERO/display_record.asp?ID=CRD42022329095, identifier: CRD42022329095.
背景
非自杀性自伤（NSSI）和自杀未遂（SA）是会导致个体身体受伤甚至死亡的风险行为，当两者同时出现时，是一个非常强大的风险因素，个体往往会出现更严重的心理和行为问题。由于不同研究对象的人口统计学特征不同，目前缺乏对这种共现情况发生率和发生情况的全面了解，难以明确临床干预的重点和未来研究方向。
方法
对截至2022年5月报告非自杀性自伤和自杀未遂共现数据的中英文相关研究进行系统检索。使用Stata 16.0软件基于随机效应模型计算非自杀性自伤和自杀未遂共现（NSSI+SA）的发生率，并按年龄组、合并症和发生时间亚组比较不同人群中的发生率差异。本研究严格按照PRISMA规范撰写，并在PROSPERO平台（CRD42022329095）上完成注册。
结果
共纳入37项研究（139573名个体）进行荟萃分析，非自杀性自伤和自杀未遂共现的合并发生率为9.6%。在不同组中，青少年和青年、成年人、普通人群以及精神疾病患者中NSSI+SA的患病率分别为10%、11%、6%和26%，12个月内NSSI+SA的共现率为17%。
结论
有相当一部分群体既有非自杀性自伤史又有自杀未遂史，且临床上症状更严重。迫切需要有针对性的预防和干预，但干预方向需要对这种共现情况的发生轨迹进行进一步研究。
系统评价注册
http://www.crd.york.ac.uk/PROSPERO/display_record.asp?ID=CRD42022329095，标识符：CRD42022329095
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