Masi Gabriele, Pisano Simone, Sesso Gianluca, Mazzullo Cristina, Berloffa Stefano, Fantozzi Pamela, Narzisi Antonio, Placini Francesca, Valente Elena, Viglione Valentina, Milone Annarita
IRCCS Fondazione Stella Maris, Scientific Institute of Child Neurology and Psychiatry, 56128 Calambrone, Italy.
Department of Translational Medical Sciences, Federico II University, 80131 Naples, Italy.
Brain Sci. 2023 May 3;13(5):755. doi: 10.3390/brainsci13050755.
Non-suicidal self-injury (NSSI) is deliberate harm to the body surface without suicidal intent, though it may be a predictor of suicide attempts. Our aim was to test the hypothesis that persisting and recovering NSSI may have a different longitudinal risk for suicidal ideation and behavior and that the intensity of Cyclothymic Hypersensitive Temperament (CHT) may increase this risk. Fifty-five patients (mean age 14.64 ± 1.77 years) referred for mood disorders according to the DSM-5 were consecutively recruited and followed-up for a mean of 19.79 ± 11.67 months and grouped according to the presence/absence of NSSI at baseline and follow-up into three groups: without NSSI (non-NSSI; n = 22), with NSSI recovered at follow-up (past-NSSI; n = 19), and with persistent NSSI at follow-up (pers-NSSI; n = 14). At follow-up, both NSSI groups were more severely impaired and failed to improve internalizing problems and dysregulation symptoms. Both NSSI groups reported higher scores in suicidal ideation compared to non-NSSI, but only pers-NSSI presented higher scores in suicidal behavior. CHT was higher in pers-NSSI, followed by past-NSSI and then by non-NSSI. Our data support a continuity between NSSI and suicidality, and they suggest the prognostic validity of persistent NSSI, associated with highest CHT scores.
非自杀性自伤（NSSI）是指故意对体表造成伤害且无自杀意图，尽管它可能是自杀未遂的一个预测因素。我们的目的是检验这样一个假设，即持续存在和已康复的NSSI可能对自杀意念和行为有不同的纵向风险，并且环性心境敏感气质（CHT）的强度可能会增加这种风险。根据《精神疾病诊断与统计手册》第5版（DSM-5）被转诊来治疗情绪障碍的55名患者（平均年龄14.64±1.77岁）被连续招募，并进行了平均19.79±11.67个月的随访，根据基线和随访时是否存在NSSI分为三组：无NSSI（非NSSI组；n = 22）、随访时NSSI已康复（既往NSSI组；n = 19）和随访时NSSI持续存在（持续NSSI组；n = 14）。在随访时，两个NSSI组的功能损害更严重，内化问题和调节障碍症状没有改善。与非NSSI组相比，两个NSSI组在自杀意念方面的得分更高，但只有持续NSSI组在自杀行为方面得分更高。持续NSSI组的CHT更高，其次是既往NSSI组，然后是非NSSI组。我们的数据支持NSSI与自杀行为之间存在连续性，并且表明持续NSSI具有预后有效性，且与最高的CHT得分相关。
