Deakin Health Economics, Deakin University, Burwood, VIC, Australia.
Monash University Health Economics Group (MUHEG), School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia.
Aust N Z J Psychiatry. 2023 Jul;57(7):952-965. doi: 10.1177/00048674231165477. Epub 2023 Apr 10.
Self-harm and suicidality are associated with substantial social and economic burden, especially among children, adolescents and young adults. The aim of this review was to systematically synthesize the literature on the association between health-related quality of life and self-harm/suicidality in children, adolescents and young adults.
Searches were conducted via MEDLINE, PsycINFO, CINAHL, EconLit and EMBASE. Search terms were the combination of the following blocks: (1) self-harm/suicidality, (2) health-related quality of life/well-being/life satisfaction and (3) children/adolescents/young adults. The quality of studies was assessed using the Effective Public Health Practice Project tool.
We identified 23 relevant studies. Findings showed that participants who reported self-harm had lower well-being, life satisfaction or overall health-related quality of life compared to those without self-harm. There was also evidence supporting the association between health-related quality of life and suicidal attempt. However, the results for the association with suicidal ideation remained inconsistent. Additionally, mental health, emotional well-being, physical health, oral health, existential well-being and family quality of life were found to be significant domains associated with self-harm or suicidality. Regarding the quality of included studies, 35% ( = 8), 39% ( = 9) and 26% ( = 6) of studies were scored as 'Strong', 'Moderate' and 'Weak', respectively.
Findings from the review showed that health-related quality of life varied according to the severity of suicidality (from ideation to attempt). There was also no evidence to infer the direction of causality between health-related quality of life and self-harm/suicidality. The findings suggest a need for further research, in particular longitudinal studies to fill identified gaps in the literature.
自残和自杀意念与行为会给儿童、青少年和年轻人带来巨大的社会和经济负担。本综述旨在系统地综合有关儿童、青少年和年轻人的健康相关生活质量与自残/自杀意念和行为之间关联的文献。
通过 MEDLINE、PsycINFO、CINAHL、EconLit 和 EMBASE 进行检索。检索词是以下三个部分的组合：（1）自残/自杀意念和行为，（2）健康相关生活质量/幸福感/生活满意度，（3）儿童/青少年/年轻人。使用有效公共卫生实践项目工具评估研究质量。
我们确定了 23 项相关研究。研究结果表明，与无自残行为的参与者相比，报告有自残行为的参与者的幸福感、生活满意度或整体健康相关生活质量较低。也有证据支持健康相关生活质量与自杀未遂之间的关联。然而，健康相关生活质量与自杀意念之间的关联结果仍不一致。此外，心理健康、情绪健康、身体健康、口腔健康、存在主义幸福感和家庭生活质量被发现是与自残或自杀意念相关的重要领域。关于纳入研究的质量，35%（=8）、39%（=9）和 26%（=6）的研究分别被评为“强”、“中”和“弱”。
本综述的结果表明，健康相关生活质量因自杀意念的严重程度（从意念到尝试）而有所不同。也没有证据可以推断健康相关生活质量与自残/自杀意念之间的因果关系方向。研究结果表明需要进一步研究，特别是需要进行纵向研究，以填补文献中的空白。
