Lorentzen Eva Amanda, Mors Ole, Kjær Jesper Nørgaard
Psychosis Research Unit, Aarhus University Hospital - Psychiatry, Aarhus, Denmark.
Department of Clinical Medicine, Aarhus University, Aarhus, Denmark.
Schizophr Bull Open. 2022 Nov 11;3(1):sgac069. doi: 10.1093/schizbullopen/sgac069. eCollection 2022 Jan.
In patients with schizophrenia spectrum disorder (SSD), the lifetime prevalence of self-harm (SH) and non-suicidal self-injury (NSSI) is currently uncertain. The primary aim of this review was to provide a synthesis of the existing literature concerning the prevalence of SH/NSSI in individuals with SSD, and individuals at clinical high risk of psychosis (CHR-P). Secondary aims were to investigate methods, severity, and functions of self-injurious behavior in these populations.
Studies quantifying the prevalence of SH/NSSI in individuals with SSD or at CHR-P were included in this review. MEDLINE, EMBASE, and PsycInfo were searched for eligible studies June 10, 2022 and systematically screened by two independent reviewers. Risk of bias was assessed using the Joana Briggs Institute Critical Appraisal Checklist for Prevalence Studies by two independent reviewers. A meta-analysis of the lifetime prevalence of SH/NSSI was conducted using generalized linear mixed model with the logit transformation.
Thirty-two studies were included in this review (15 440), 4 of which included individuals at CHR-P (). The meta-analysis showed a pooled lifetime prevalence of SH of 31.0% (95% CI: 22.1%; 41.6%) in individuals with SSD ( and 39.7% (95% CI: 17.5%; 70.0%) in individuals at CHR-P (). These estimates should be interpreted with caution due to substantial heterogeneity. Cutting was the most frequent method of SH/NSSI and SH command hallucinations may be an overlooked cause of self-injurious behavior in these patients.
Self-injurious behavior is a highly prevalent, and possibly overlooked concern, in individuals with SSD and at CHR-P.
在精神分裂症谱系障碍（SSD）患者中，自我伤害（SH）和非自杀性自伤（NSSI）的终生患病率目前尚不确定。本综述的主要目的是综合现有关于SSD患者以及临床高风险精神病个体（CHR-P）中SH/NSSI患病率的文献。次要目的是研究这些人群中自伤行为的方法、严重程度和功能。
本综述纳入了量化SSD患者或CHR-P个体中SH/NSSI患病率的研究。于2022年6月10日在MEDLINE、EMBASE和PsycInfo中检索符合条件的研究，并由两名独立评审员进行系统筛选。两名独立评审员使用乔安娜·布里格斯研究所患病率研究批判性评价清单评估偏倚风险。使用对数转换的广义线性混合模型对SH/NSSI的终生患病率进行荟萃分析。
本综述纳入了32项研究（共15440名参与者），其中4项研究纳入了CHR-P个体。荟萃分析显示，SSD患者中SH的合并终生患病率为31.0%（95%CI：22.1%；41.6%），CHR-P个体中的患病率为39.7%（95%CI：17.5%；70.0%）。由于存在显著异质性，这些估计值应谨慎解读。切割是SH/NSSI最常见的方式，而命令性幻听可能是这些患者自伤行为中一个被忽视的原因。
自伤行为在SSD患者和CHR-P个体中非常普遍，且可能是一个被忽视的问题。
