Boylan Khrista, Duncan Laura, Wang Li, Manion Ian, Bennett Kathryn, Colman Ian, Georgiades Katholiki
Department of Psychiatry and Behavioural Neurosciences, Faculty of Health Sciences, McMaster University, Hamilton, Canada.
Department of Health Evidence and Impact, Faculty of Health Sciences, McMaster University, Hamilton, Canada.
Can J Psychiatry. 2025 May 15:7067437251337609. doi: 10.1177/07067437251337609.
ObjectivesNon-suicidal self-injury (NSSI) is a common behaviour in youth with mental disorder and in the general population. While NSSI is an important predictor of suicide attempts, not all youth with NSSI experience this outcome. The objective of this study is to report on the overlap between NSSI and suicidal ideation or attempt among Canadian youth self-reporting these behaviours in the general population to define a group of youth who engage in NSSI alone. This group of youth may represent a unique clinical phenotype.MethodsWe used data from 14-17 year olds ( = 2,576) from the 2014 Ontario Child Health Study, a province-wide, cross-sectional, epidemiologic study of child health and mental disorder. Based on their responses to questions about past year experiences of suicidal thoughts and behaviours including NSSI, 6 mutually exclusive groups were created reflecting their differing profiles of suicidal thoughts and behaviours. These groups were compared to each other on socio-demographic and symptom characteristics.ResultsA total of 9.2% of youth reported NSSI, and half of these youth endorsed NSSI alone (without suicidal ideation or attempts). Both groups had significantly more females. Compared to other groups of youth endorsing suicidal thoughts and behaviours, the NSSI alone group had lower symptoms of mental disorder in all domains except for social anxiety symptoms. They also had the lowest perceived need for help of all groups.ConclusionsAbout half of youth who self-harm do so without suicidal intent, and some for as long as 1 year during adolescence. Further prospective study of youth with NSSI alone is needed, to determine symptom stability as well as incident more risky suicidal behaviour before recommendations regarding the appropriateness of minimal medical or psychological intervention for youth who engage in this behaviour can be considered. There also are important sex differences in NSSI that deserve additional prospective study.
目标
非自杀性自伤行为（NSSI）在患有精神障碍的青少年以及普通人群中都是一种常见行为。虽然NSSI是自杀未遂的一个重要预测指标，但并非所有有NSSI行为的青少年都会出现这种结果。本研究的目的是报告在加拿大普通人群中自我报告有这些行为的青少年中，NSSI与自杀意念或自杀未遂之间的重叠情况，以界定一组仅实施NSSI行为的青少年群体。这组青少年可能代表一种独特的临床表型。
方法
我们使用了来自2014年安大略儿童健康研究中14 - 17岁青少年（n = 2576）的数据，该研究是一项全省范围的关于儿童健康和精神障碍的横断面流行病学研究。根据他们对过去一年中包括NSSI在内的自杀想法和行为经历问题的回答，创建了6个相互排斥的组，反映他们不同的自杀想法和行为特征。对这些组在社会人口统计学和症状特征方面进行了相互比较。
结果
共有9.2%的青少年报告有NSSI行为，其中一半的青少年仅实施NSSI行为（无自杀意念或自杀未遂）。两组中的女性比例都显著更高。与其他认可有自杀想法和行为的青少年组相比，仅实施NSSI行为的组在除社交焦虑症状外的所有领域中精神障碍症状都更低。在所有组中，他们感觉到的求助需求也是最低的。
结论
约一半的自我伤害青少年并无自杀意图，且部分青少年在青春期会持续长达1年。需要对仅实施NSSI行为的青少年进行进一步的前瞻性研究，以确定症状稳定性以及更具风险的自杀行为的发生率，然后才能考虑针对有此类行为的青少年进行最小限度医学或心理干预是否合适的建议。在NSSI行为方面也存在重要的性别差异，值得进行更多的前瞻性研究。
