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1.
BMJ Open ; 13(2): e069748, 2023 Feb 01.
Artigo em Inglês | MEDLINE | ID: mdl-36725102

RESUMO

INTRODUCTION: Young people are the most frequent users of social media and smartphones and there has been an increasing speculation about the potential negative impacts of their use on mental health. This has coincided with a sharp increase in the levels of self-harm in young people. To date, studies researching this potential association are predominantly cross-sectional and reliant on self-report data, which precludes the ability to objectively analyse behaviour over time. This study is one of the first attempts to explore temporal patterns of real-world usage prior to self-harm, to identify whether there are usage patterns associated with an increased risk. METHODS AND ANALYSIS: To study the mechanisms by which social media and smartphone use underpin self-harm in a clinical sample of young people, the Social media, Smartphone use and Self-harm in Young People (3S-YP) study uses a prospective, observational study design. Up to 600 young people aged 13-25 years old from secondary mental health services will be recruited and followed for up to 6 months. Primary analysis will compare real-world data in the 7 days leading up to a participant or clinician recorded self-harm episode, to categorise patterns of problematic usage. Secondary analyses will explore potential mediating effects of anxiety, depression, sleep disturbance, loneliness and bullying. ETHICS AND DISSEMINATION: This study was approved by the National Research Ethics Service, London - Riverside, as well as by the Joint Research and Development Office of the Institute of Psychiatry, Psychology and Neuroscience and South London and Maudsley NHS Foundation Trust (SLaM), and the SLaM Clinical Research Interactive Search (CRIS) Oversight Committee. The findings from this study will be disseminated through peer-reviewed scientific journals, conferences, websites, social media and stakeholder engagement activities. TRIAL REGISTRATION NUMBER: NCT04601220.


Assuntos
Comportamento Autodestrutivo , Mídias Sociais , Humanos , Adolescente , Adulto Jovem , Adulto , Smartphone , Estudos Prospectivos , Estudos Transversais , Comportamento Autodestrutivo/epidemiologia , Comportamento Autodestrutivo/psicologia , Estudos Observacionais como Assunto
2.
Lancet Public Health ; 8(2): e99-e108, 2023 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-36709062

RESUMO

BACKGROUND: A socioeconomically disadvantaged childhood has been associated with elevated self-harm and violent criminality risks during adolescence and young adulthood. However, whether these risks are modified by a neighbourhood's socioeconomic profile is unclear. The aim of our study was to compare risks among disadvantaged young people residing in deprived areas versus risks among similarly disadvantaged individuals residing in affluent areas. METHODS: We did a national cohort study, using Danish interlinked national registers, from which we delineated a longitudinal cohort of people born in Denmark between Jan 1, 1981, and Dec 31, 2001, with two Danish-born parents, who were alive and residing in the country when they were aged 15 years, who were followed up for a hospital-treated self-harm episode or violent crime conviction. A neighbourhood affluence indicator was derived based on nationwide income quartiles, with parental income and educational attainment indicating the socioeconomic position of each cohort member's family. Bayesian multilevel survival analyses were done to examine the moderating influences of neighbourhood affluence on associations between family socioeconomic position and sex-specific risks for the two adverse outcomes. FINDINGS: 1 084 047 cohort members were followed up for 12·8 million person-years in aggregate. Individuals of a low socioeconomic position residing in deprived neighbourhoods had a higher incidence of both self-harm and violent criminality compared with equivalently disadvantaged peers residing in affluent areas. Women from a low-income background residing in affluent areas had, on average, 95 (highest density interval 76-118) fewer self-harm episodes and 25 (15-41) fewer violent crime convictions per 10 000 person-years compared with women of an equally low income residing in deprived areas, whereas men of a low income residing in affluent areas had 61 (39-81) fewer self-harm episodes and 88 (56-191) fewer violent crime convictions per 10 000 person-years than men of a low income residing in deprived areas. INTERPRETATION: Even in a high-income European country with comprehensive social welfare and low levels of poverty and inequality, individuals residing in affluent neighbourhoods have lower risks of self-harm and violent criminality compared with individuals residing in deprived neighbourhoods. More research is needed to explore the potential of neighbourhood policies and interventions to reduce the harmful effects of growing up in socioeconomically deprived circumstances on later risk of self-harm and violent crime convictions. FUNDING: European Research Council, Lundbeck Foundation Initiative for Integrative Psychiatric Research, and BERTHA, the Danish Big Data Centre for Environment and Health funded by the Novo Nordisk Foundation Challenge Programme.


Assuntos
Comportamento Autodestrutivo , Masculino , Adolescente , Humanos , Feminino , Adulto Jovem , Adulto , Estudos de Coortes , Teorema de Bayes , Comportamento Autodestrutivo/epidemiologia , Comportamento Autodestrutivo/psicologia , Comportamento Criminoso , Pobreza , Dinamarca/epidemiologia
3.
Artigo em Inglês | MEDLINE | ID: mdl-36674195

RESUMO

Drawing on the resilience-oriented socioecological framework, the current study contributes to scarce scholarship by exploring intrapersonal (i.e., gratitude) and interpersonal (i.e., parental autonomy support) factors in the longitudinal association between bullying victimization and adolescent non-suicidal self-injury (NSSI). Participants were 238 Chinese adolescents (Mage at Time 1 (T1) = 13.45 years; 106 girls and 132 boys) based on a two-wave prospective design with data spanning one year. At T1, adolescents self-rated all study variables, and at Time 2 (T2), youth again reported their NSSI. The results showed a significant main effect (b = 0.12, SE = 0.05, p = 0.04), indicating that bullying victimization was positively related to T2 NSSI one year later, even controlling for T1 NSSI. Moderation analyses further indicated that parental autonomy support buffered against the positive association between bullying victimization and T2 NSSI, but only when adolescents experienced lower levels of gratitude. Specifically, for adolescents with lower levels of gratitude, high levels of parental autonomy support, in a compensatory way, prevented adolescents from NSSI after victimization occurred (b = -0.03, SE = 0.09, p = 0.78); by contrast, for those with higher levels of gratitude, bullying victimization was not significantly related to T2 NSSI, regardless of the levels of parental autonomy support (b = 0.07, SE = 0.04, p = 0.59 for higher parental autonomy support; b = 0.01, SE = 0.07, p = 0.93 for lower parental autonomy support). These findings suggest that gratitude and parental autonomy support, manifesting in a compensatory interaction pattern, could serve as targeted agents for breaking the vicious linkage between bullying victimization and NSSI.


Assuntos
Comportamento do Adolescente , Bullying , Vítimas de Crime , Comportamento Autodestrutivo , Masculino , Feminino , Humanos , Adolescente , Comportamento Autodestrutivo/epidemiologia
4.
Eur Psychiatry ; 66(1): e13, 2023 Jan 18.
Artigo em Inglês | MEDLINE | ID: mdl-36649931

RESUMO

BACKGROUND: Persons discharged from inpatient psychiatric services are at greatly elevated risk of harming themselves or inflicting violence on others, but no studies have reported gender-specific absolute risks for these two outcomes across the spectrum of psychiatric diagnoses. We aimed to estimate absolute risks for self-harm and interpersonal violence post-discharge according to gender and diagnostic category. METHODS: Danish national registry data were utilized to investigate 62,922 discharged inpatients, born 1967-2000. An age and gender matched cohort study was conducted to examine risks for self-harm and interpersonal violence at 1 year and at 10 years post-discharge. Absolute risks were estimated as cumulative incidence percentage values. RESULTS: Patients diagnosed with substance misuse disorders were at especially elevated risk, with the absolute risks for either self-harm or interpersonal violence being 15.6% (95% CI 14.9, 16.3%) of males and 16.8% (15.6, 18.1%) of females at 1 year post-discharge, rising to 45.7% (44.5, 46.8%) and 39.0% (37.1, 40.8%), respectively, within 10 years. Diagnoses of personality disorders and early onset behavioral and emotional disorders were also associated with particularly high absolute risks, whilst risks linked with schizophrenia and related disorders, mood disorders, and anxiety/somatoform disorders, were considerably lower. CONCLUSIONS: Patients diagnosed with substance misuse disorders, personality disorders and early onset behavioral and emotional disorders are at especially high risk for internally and externally directed violence. It is crucial, however, that these already marginalized individuals are not further stigmatized. Enhanced care at discharge and during the challenging transition back to life in the community is needed.


Assuntos
Serviços de Saúde Mental , Comportamento Autodestrutivo , Transtornos Relacionados ao Uso de Substâncias , Masculino , Feminino , Humanos , Alta do Paciente , Pacientes Internados/psicologia , Estudos de Coortes , Assistência ao Convalescente , Comportamento Autodestrutivo/diagnóstico , Comportamento Autodestrutivo/epidemiologia , Violência/psicologia , Transtornos Relacionados ao Uso de Substâncias/diagnóstico , Transtornos Relacionados ao Uso de Substâncias/epidemiologia , Transtornos Relacionados ao Uso de Substâncias/complicações , Fatores de Risco
5.
PLoS One ; 18(1): e0278446, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-36602997

RESUMO

There has been limited longitudinal investigation to date into the association between bullying, self-harm, and suicidality in Australia and the impact of specific demographic differences on this relationship. This is despite the continued rise in the incidence of bullying, self-harm, and suicide. As such, the current study draws on data from the Longitudinal Survey of Australian children (LSAC) to examine the association between bullying, self-harm, and suicidality and explore the impact of demographic differences across three bullying related behaviors (being bullied, bullying others and being both bullied and bullying others). The evidence indicates that bully-victims exhibit the highest risk of self-harm and suicidality in Australia. When considering demographic differences, it was identified that females and adolescents aged 16-17-years-of-age had the highest risk of self-harm and suicidality. Further, a direct curvilinear relationship between age and the categories of self-harm was identified with an inflection point around 16-17 years. The study supports the need for further investigation into the association between bullying, self-harm, and suicidality longitudinally with a particular focus on other moderators.


Assuntos
Bullying , Vítimas de Crime , Comportamento Autodestrutivo , Suicídio , Adolescente , Feminino , Humanos , Criança , Estudos de Coortes , Austrália/epidemiologia , Comportamento Autodestrutivo/epidemiologia , Comportamento Autodestrutivo/etiologia
6.
Int J Eat Disord ; 56(2): 439-445, 2023 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-36524669

RESUMO

OBJECTIVE: Little is known about the co-occurrence of nonsuicidal self-injurious (NSSI) behaviors and eating disorder (ED) pathology in community samples of adolescents. METHODS: A total of 1558 Norwegian upper secondary school students (Grades 11, 12, and 13) completed the Deliberate Self-Harm Inventory and a measure of ED pathology. RESULTS: Adolescents (53.1% F, 46.9% M) were a mean age of 17.1 years. A higher level of ED pathology was reported (12.1 vs. 5.3, p < .001) among adolescents who had a history of NSSI. Significantly higher levels of ED pathology were found among females who reported hitting themselves until bruised, head banging, severe scratching, and burning with a lighter, but not cutting, or the other forms of self-injury. Of adolescents with a history of NSSI, 60% of females and 15% of males scored above a cutoff for ED pathology. Of adolescents scoring above a cutoff for ED pathology, 42.5% of females and 37.1% of males had engaged in lifetime NSSI. DISCUSSION: Adolescents-in particular, females- with a history of NSSI reported significantly greater ED pathology. Notably, a higher proportion of males with ED pathology reported lifetime self-injury than vice versa, underscoring the importance of carefully screening for the presence of self-harm among males with ED pathology. PUBLIC SIGNIFICANCE STATEMENT: Over 1500 upper secondary school students with an average age of 17 years completed an online survey assessing current ED pathology and lifetime NSSI. Adolescents, particularly females, with a history of self-harm reported significantly more ED pathology. Findings also indicated the need to carefully screen for self-harm among males with ED pathology. Parents, schools, and health professionals should be aware that self-harm and ED pathology commonly co-occur and warrant assessment.


Assuntos
Transtornos da Alimentação e da Ingestão de Alimentos , Comportamento Autodestrutivo , Masculino , Feminino , Humanos , Adolescente , Comportamento Autodestrutivo/diagnóstico , Comportamento Autodestrutivo/epidemiologia , Comportamento Autodestrutivo/complicações , Inquéritos e Questionários , Transtornos da Alimentação e da Ingestão de Alimentos/diagnóstico , Transtornos da Alimentação e da Ingestão de Alimentos/epidemiologia , Conscientização , Instituições Acadêmicas
7.
J Affect Disord ; 320: 161-168, 2023 01 01.
Artigo em Inglês | MEDLINE | ID: mdl-36162662

RESUMO

BACKGROUND: Few studies have been conducted focusing on the non-suicidal self-injury (NSSI) incidence rate and influencing factors among left-behind children in northeastern Sichuan, China. In this study, we investigated the incidence rate of the NSSI behaviors, levels of anxiety and depression in left-behind children in northeastern Sichuan, and relevant sociodemographic factors. METHODS: The NSSI behaviors were identified using the Ottawa Self-injury Inventory (Chinese version). Its incidence rate and related influencing factors were evaluated by Cluster sampling; the Depression Anxiety Stress Scale-21 Items (DASS-21) was adopted to assess the levels of anxiety, depression, and stress. RESULTS: A total of 9450 adolescents met the inclusion criteria, including 543 with NSSI behaviors, and the prevalence of NSSI was 5.7 %. There were 3596 left-behind children, and 243 of them had NSSI behaviors, the NSSI incidence in left-behind children was 6.8 %. There were 5854 non-left-behind children, and the NSSI incidence in non-left-behind children was 5.1 %. Left-behind children's NSSI behaviors were remarkably correlated with five risk factors: being female (OR = 2.411, 95%CI = 1.773-3.279), parents' divorce (OR = 1.742, 95%CI = 1.262-2.404), elder age (OR = 1.120, 95%CI = 1.028-1.219), severe depression (OR = 1.212, 95%CI = 1.148-1.281), and high anxiety (OR = 1.170, 95%CI = 1.093-1.251). LIMITATIONS: This is a cross-sectional study, we cannot probe into the causality between NSSI behaviors and corresponding risk factors. Reporting and recalling biases may be unavoidable as questionnaires are performed by self-rating scales and retrospective reports. CONCLUSION: The NSSI behaviors are common in left-behind children in northeastern Sichuan. This study proposes that prevention and intervention measures are necessary for the healthy growth of such children.


Assuntos
Comportamento Autodestrutivo , Humanos , Adolescente , Criança , Feminino , Idoso , Masculino , Estudos Transversais , Estudos Retrospectivos , Comportamento Autodestrutivo/epidemiologia , Ansiedade/epidemiologia , Prevalência
8.
J Affect Disord ; 320: 140-147, 2023 01 01.
Artigo em Inglês | MEDLINE | ID: mdl-36181912

RESUMO

BACKGROUND: Previous research has found increasing evidence of adverse childhood experiences (ACEs) leading to non-suicidal self-injury (NSSI) and suicidal behaviors. Most studies have focused on a certain type or timing of ACEs or the patterns of multiple types; however, few of them have examined the patterns of ACEs combined types and timing and the gender differences in the association between ACEs and self-harming behaviors. METHODS: A cross-sectional survey was conducted in three Chinese cities from November 2020 to May 2021. We asked 16,853 middle school students to anonymously complete a questionnaire to provide the details of their own ACEs and NSSI or suicidal behaviors. RESULTS: Latent class analysis identified four classes: high ACEs (10 %), high abuse/neglect (20.3 %), moderate ACEs (26.7 %) and low ACEs (43 %). Logistic regression models demonstrated that students in the high ACEs, high abuse/neglect and moderate ACEs subgroups were more likely to engage in NSSI and suicidal behaviors than students with low ACEs. Compared with boys, girls had a higher probability of engaging in NSSI and suicidal behaviors when exposed to the same level of ACEs. CONCLUSION: Co-occurrence of ACEs is associated with high risk of NSSI and suicidal behaviors. Our findings recognized the most dangerous patterns and latent class membership, which supply the evidence for policy makers to adopt preventive measures to protect high-risk individuals. Strategies to relieve the impact of ACEs, especially on girls, need to be considered comprehensively. LIMITATIONS: The study was limited by cross-sectional design, as causality could not be confirmed. In addition, because our survey was retrospective, potential recall bias can not be ignored.


Assuntos
Experiências Adversas da Infância , Comportamento Autodestrutivo , Humanos , Masculino , Feminino , Fatores Sexuais , Cidades , Estudos Transversais , Estudos Retrospectivos , Ideação Suicida , Comportamento Autodestrutivo/epidemiologia , Estudantes , China/epidemiologia , Inquéritos e Questionários , Fatores de Risco
9.
J Affect Disord ; 323: 707-715, 2023 Feb 15.
Artigo em Inglês | MEDLINE | ID: mdl-36529405

RESUMO

BACKGROUNDS: PTSD is one of the most common conditions after people have experienced trauma. While previous studies have found a link between PTSD and non-suicidal self-injury, (NSSI), few studies have longitudinally explored this relationship and the underlying mechanisms. AIMS: This study explored adolescent NSSI frequency after COVID-19 lockdown experiences, the relationship with early PTSD symptoms, and the mediating role of depression and sleep problems. METHODS: A cohort of 1609 adolescents completed two surveys during and after the national lockdown in China; one month into the lockdown and six months later; which assessed demographic and pandemic-related exposure variables; PTSD, depression, sleep, and NSSI. Mediation analyses and hierarchical regression were employed to examine the relationships and the paths between these variables. RESULTS: The NSSI rate was found to be 31.9 % after the three-month lockdown, with 20.6 % of adolescent participants reporting sleeping disorders, and 33.9 % indicating probable depression. Adolescents who had earlier PTSD symptoms, often smoked and/or drank, and had current depression and sleep disorders reported greater NSSI. Early PTSD symptoms were found to predict later NSSI and were mediated by sleep problems and depressive symptoms. Specifically, PTSD avoidance and numbing symptoms were significantly associated with NSSI above and beyond the depressive symptoms, sleeping problems, and the other covariables. CONCLUSION: It is necessary to be vigilant about the increased risk of NSSI in adolescents who have experienced extended pandemic lockdowns. Preventing early adolescent PTSD symptoms, especially avoidance and numbness, and helping teenagers quit smoking and drinking could reduce the risk of sleep disorders, depression, and NSSI.


Assuntos
COVID-19 , Comportamento Autodestrutivo , Transtornos do Sono-Vigília , Transtornos de Estresse Pós-Traumáticos , Humanos , Adolescente , Transtornos de Estresse Pós-Traumáticos/epidemiologia , Transtornos de Estresse Pós-Traumáticos/diagnóstico , Pandemias , COVID-19/epidemiologia , Controle de Doenças Transmissíveis , Comportamento Autodestrutivo/epidemiologia , Transtornos do Sono-Vigília/epidemiologia
10.
J Affect Disord ; 324: 129-135, 2023 Mar 01.
Artigo em Inglês | MEDLINE | ID: mdl-36586591

RESUMO

OBJECTIVE: Depressive disorders (DD) are highly prevalent among adolescents. While up to 60 % do not respond to treatment, evidence on predictors of treatment non-response in this age group is mixed, impeding meaningful clinical implications. Drawing on a consecutive clinical cohort of adolescents with risk taking and self-injurious behavior, the present study aimed to identify predictors of treatment non-response for female DD in a naturalistic one year follow-up. METHODS: The sample comprised female adolescents with verified DD (n = 152). Patients underwent assessments at baseline (T0) and follow-up (T1). Sociodemographic factors (e.g., age), clinical measures (e.g., symptom severity, trauma), and treatment variables (e.g. number of psychotherapy sessions), were analyzed as potential predictors of treatment non-response in unadjusted analyses and analyses adjusting for treatment intensity and age at baseline. Treatment response was defined based on not fulfilling formal diagnosis for DD at follow-up (52.3 %; n = 80) or the 50 % decrease in self-reported depressive symptoms (21.1 %; n = 32) from T0 to T1. RESULTS: Greater depressive and overall symptom severity, greater frequency of self-injuries, history of suicide attempts and history of childhood trauma at T0 were robustly associated with treatment non-response based on diagnostic interviews. Only a lower number of siblings was robustly associated with treatment non-response based on self-reports. LIMITATIONS: Findings may not generalize to other treatment settings. CONCLUSION: Collectively, our results highlight overall symptom severity as significant predictor of treatment non-response in female adolescents with depression. Methodological differences (interviews versus self-reports) and potential implications from these findings for clinical practice are discussed.


Assuntos
Depressão , Comportamento Autodestrutivo , Humanos , Adolescente , Feminino , Depressão/diagnóstico , Depressão/epidemiologia , Depressão/terapia , Seguimentos , Comportamento Autodestrutivo/epidemiologia , Comportamento Autodestrutivo/terapia , Comportamento Autodestrutivo/diagnóstico , Tentativa de Suicídio/prevenção & controle , Assunção de Riscos
11.
Psychiatry Res ; 319: 115002, 2023 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-36549098

RESUMO

Nonsuicidal Self-Injury (NSSI), the purposeful harming of one's body tissue without suicidal intent. NSSI frequently co-occurs with other self-destructive forms of psychopathology, such as eating disorders (ED); however, it remains unclear if ED behaviors are used as a form of NSSI. This exploratory study examined the occurrence of Self-Injurious Disordered Eating Symptoms (SIDES), as well as differences in clinical correlates and treatment outcomes between NSSI patients with and without SIDES. Participants included 1,327 patients admitted for partial hospitalization or intensive outpatient treatment for NSSI (87.4% female; 75.3% Non-Hispanic White). Data were collected at admission and discharge as part of routine clinical outcome assessment. Results indicate that 29.5% of the sample engaged in SIDES, while most were not diagnosed with an ED. Patients that engaged in SIDES reported greater clinical severity at baseline, including greater general psychopathology, lower quality of life, and worse functional impairment, as well as more clinically severe NSSI (e.g., greater number of methods, higher urge to self-injure, greater intrapersonal functions). No differences in treatment outcomes were found. These findings suggest that some NSSI patients perceive ED behaviors as a form of NSSI and that SIDES may be a marker for a more severe clinical presentation.


Assuntos
Transtornos da Alimentação e da Ingestão de Alimentos , Comportamento Autodestrutivo , Humanos , Feminino , Masculino , Qualidade de Vida , Comportamento Autodestrutivo/epidemiologia , Ideação Suicida , Psicopatologia
12.
Injury ; 54(1): 232-237, 2023 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-36503837

RESUMO

OBJECTIVES: The objective of this study is to present a retrospective analysis of patients presenting to a Major Trauma Centre (MTC) following deliberate self-harm (DSH) and identifying the precipitants of DSH and psychiatric morbidity that will serve to inform the provision of care for these patients. PATIENTS AND METHODS: This was a retrospective observational study from a London Major Trauma Centre that identified all injured patients that presented with deliberate self-harm. Data was analysed from our established trauma database. The data was analysed using descriptive statistics. RESULTS: This included 347 patients of whom 253 were male and 94 were female. The median age was 36 (range 14-93) years. Penetrating injuries (shooting and stabbing) occurred in 187 (54%) patients and blunt injuries in 160 (46%) patients. Self-stabbing (52%) was the most common cause for presentation followed by jumping from a height (26%). The median Injury Severity Score (ISS) was 4 (range 1-9). The median LOS was 3 days (range 0-109), with a mean stay of 8 days. Over half of the patients (n = 189) had previous contact with mental health services. Social and mental health were the main triggers for DSH. CONCLUSIONS: Societal and economic factors as well as a mental disorder are associated with trauma related DSH. These complex group of patients presenting to MTCs have not only acute surgical needs but social and psychological as well. Raising awareness of patients' mental health needs across the whole pathway for the major trauma patient is crucial to ensure that appropriate risk assessments are undertaken at every stage. It is also essential to provide psychological support to the multi-disciplinary team for their wellbeing.


Assuntos
Comportamento Autodestrutivo , Ferimentos Penetrantes , Humanos , Masculino , Feminino , Adolescente , Adulto Jovem , Adulto , Pessoa de Meia-Idade , Idoso , Idoso de 80 Anos ou mais , Centros de Traumatologia , Comportamento Autodestrutivo/epidemiologia , Comportamento Autodestrutivo/psicologia , Londres/epidemiologia , Estudos Retrospectivos
13.
Asian J Psychiatr ; 79: 103405, 2023 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-36521403

RESUMO

Descriptive analysis of adolescent mental disorders in Huangshi was performed to explore the gender differences, influencing factors, and abnormal illness behaviors. A total of 674 patients in Huangshi Mental Health Center from 2017 to 2022 were collected. A rising trend of mental disorders has been observed since 2018, especially during the COVID-19 pandemic. More young cases led to suicidal attempts and self-harm, which reflects the severity of mental health in adolescents. This study aims to draw the attention of government, society, families, and schools to care about adolescents, which also provides guidance and references for clinical treatment of mental disorders.


Assuntos
COVID-19 , Transtornos Mentais , Comportamento Autodestrutivo , Humanos , Adolescente , Ideação Suicida , Pandemias , COVID-19/epidemiologia , Transtornos Mentais/epidemiologia , Transtornos Mentais/terapia , Comportamento Autodestrutivo/epidemiologia , Comportamento Autodestrutivo/psicologia , China/epidemiologia , Fatores de Risco
14.
Am J Emerg Med ; 63: 50-54, 2023 01.
Artigo em Inglês | MEDLINE | ID: mdl-36327749

RESUMO

BACKGROUND: There has been an increasing incidence of self-harm attempts in recent years in the United States. Particularly concerning, there has been a growing trend of self-harm in the adolescent and young adult population. In order to inform initiatives to address this trend, risk factors and substances used for self-harm need to be clarified. METHODS: This is a descriptive retrospective observational study on all cases of self-harm poisoning in patients between the ages of 12 and 25 years reported at the state's only tertiary care center from January 2019 through March 2022. RESULTS: There was an increased incidence of 69% for self-harm poisonings for all ages and a 90% increase in ages 12-17 years between the years 2019 and 2021. Fifty percent of all cases occurred in patients aged 14-17 years, 69% were female, and 22% required an intensive care unit. The top three most common substances used are available without a prescription. DISCUSSION: There was a persistent increase in self-harm attempts via poisoning throughout the study period with a particularly vulnerable period in the adolescent age group.


Assuntos
Comportamento Autodestrutivo , Humanos , Feminino , Adolescente , Criança , Adulto Jovem , Adulto , Masculino , Centros de Atenção Terciária , Comportamento Autodestrutivo/epidemiologia
15.
Child Abuse Negl ; 136: 105993, 2023 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-36584519

RESUMO

BACKGROUND: Nonsuicidal self-injury (NSSI) is a widespread public health issue in adolescents. Exploring the risk and protective variables of NSSI is critical for prevention and intervention. Based on the experiential avoidance model (Chapman et al., 2006) and Nock's (2009) integrated model of NSSI, the current study tested a moderated mediation model to examine the impact of two risk factors, childhood abuse and depression, and one protective factor, self-compassion, on NSSI. METHODS: Self-report measures were conducted among 758 Chinese adolescents (329 females and 429 males, mean age = 14.16 years, SD = 1.92) in Hong Kong, China regarding childhood abuse, depression, self-compassion, and NSSI. RESULTS: Childhood abuse was found to be positively linked to NSSI, and this connection was mediated by depression. Self-compassion weakened the strength between childhood abuse and NSSI, along with that between childhood abuse and depression. CONCLUSIONS: These results assist in understanding how NSSI develops and facilitate future studies to investigate how the risk and protective variables for NSSI interact. The clinical application of these findings was also discussed.


Assuntos
Maus-Tratos Infantis , Comportamento Autodestrutivo , Masculino , Feminino , Humanos , Adolescente , Criança , Autocompaixão , Depressão/epidemiologia , Comportamento Autodestrutivo/epidemiologia , Maus-Tratos Infantis/prevenção & controle , Autorrelato
16.
Schizophr Res ; 251: 30-36, 2023 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-36529105

RESUMO

There is a well-documented epidemiological association between auditory hallucinations and self-harm in the general population. However, there has been limited research examining specific characteristics of auditory hallucinations (e.g., type, source, or context of voices) as correlates of self-harm. We used prospective data from the Tokyo Teen Cohort to explore whether characteristics of voices reported at age 14 were differentially associated with self-harm behaviors at ages 14 and 16. Among respondents with auditory hallucinations, respondents who experienced voices that "said something bad" about them or commented on their thoughts and actions were most likely to report concurrent self-harm, whereas positive or praising voices were protective. Negative voices continued to predict self-harm two years later, at age 16, even with adjustment for self-harm at age 14. The age of the voices, source of the voices, and context (e.g., falling asleep or while sick) was not associated with likelihood of reporting concurrent or subsequent self-harm behaviors. Assessing for negative voices in particular, rather than auditory hallucinations or psychotic experiences more broadly, may provide a more specific indicator of risk for self-harm among adolescents. The real-world utility of these epidemiological findings should be further examined in clinical settings.


Assuntos
Transtornos Psicóticos , Comportamento Autodestrutivo , Adolescente , Humanos , Transtornos Psicóticos/epidemiologia , Estudos Prospectivos , Alucinações/epidemiologia , Comportamento Autodestrutivo/epidemiologia
17.
J Interpers Violence ; 38(1-2): NP565-NP587, 2023 01.
Artigo em Inglês | MEDLINE | ID: mdl-35358398

RESUMO

Background: Identifying deliberate self-harm (DSH) and peer victimization in adolescents is a public health issue. The present study evaluates a three-wave longitudinal model to examine the effect of peer victimization on DSH and the roles of internalizing problems (depression and anxiety) and perceived peer and teacher support climate in this relationship. Methods: The participants were 2381 adolescents (51.2% boys, Mage = 13.38, SD = .59) from Chinese middle schools. Self-report measures were used to collect data every 6 months in three waves. Results: (1) Peer victimization at T1 positively predicted DSH at T3. (2) Depression at T2, rather than anxiety, mediated the relationship between peer victimization at T1 and DSH at T3. (3) Perceived peer support climate at T1 played a moderating role between peer victimization at T1 and depression and anxiety at T2, but perceived teacher support climate did not. Peer victimization had a stronger predictive effect on depression and anxiety for students with high level of perceived peer support climate. Limitations: Study limitations include the short interval (6 months) of the longitudinal design, the reliance on self-report questionnaires, the inclusion of only one aspect of student-student and teacher-student relationships, and the age limitation. Conclusions: The results demonstrated the importance of prevention for improving social and emotional skills to reduce peer victimization and of interventions to promote a peer support climate in the classroom. The findings highlight the need to consider different types of internalizing problems and perceived support in studies of DSH in adolescents.


Assuntos
Bullying , Vítimas de Crime , Comportamento Autodestrutivo , Masculino , Adolescente , Humanos , Feminino , Bullying/psicologia , Vítimas de Crime/psicologia , Grupo Associado , Estudantes/psicologia , Comportamento Autodestrutivo/epidemiologia , Comportamento Autodestrutivo/psicologia
18.
PeerJ ; 10: e14507, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36523466

RESUMO

Background: Nonsuicidal self-injury (NSSI) behaviors-an important factor that profoundly affects the physical and mental health of young people-are induced by complex and diverse factors, while showing significant differences at the gender level. We examined mediating behaviors among parenting styles, students' coping styles, and endogenous and exogenous influencing variables of adolescents' NSSI behaviors. Methods: In this cross-sectional study, Secondary school students in Ningbo, Zhejiang Province, China (n = 2,689; F/M:1532/1157) were surveyed for basic attributes, parenting styles, coping styles, and NSSI behaviors. After the initial screening of the sample data, several external derivatives were screened based on the single factor analysis method. On this basis, the construction of path analysis models under multivariate multiple elicitations was carried out. Results: The overall prevalence of NSSI was 15.16%, and the incidence of NSSI in boys was lower than that in girls (OR = 0.334, 95% CI [0.235-0.474]). The path analysis model data fit well; the indicators of female and male part are: CFI = 0.913/0.923, GFI = 0.964/0.977, SRMR = 0.055/0.047, RMSEA = 0.097/0.069 with 90% confidence interval (CI) [0.084-0.111]/[0.054-0.084]. For female, when negative coping style and extreme education affect NSSI respectively, the standardized path coefficient values are 0.478 (z = 20.636, P = 0.000 < 0.01) and 0.151 (z = 6.524, P = 0.000 < 0.01) respectively, while for male, the corresponding values become 0.225 (z = 7.057, P < 0.001) and 0.104 (z = 3.262, P < 0.001). Conclusion: In particular, we investigated the mediating effects of gender-specific NSSI influences and found that NSSI behaviors were strongly associated with environmental variables and individual factors, especially family parenting style and adolescent coping style, which influenced NSSI in a gender-specific manner. The results showed that males were the target of both positive and negative parenting styles, whereas females were more likely to choose negative coping styles directed towards emotions in response to external stimuli, and instead showed a more significant predisposition towards NSSI behaviors. This phenomenon seems to be influenced by multilevel factors such as sociocultural, individual value identity, and physiological structure differences. In the path analysis model with the introduction of mediating effects, the influence of gender differences on NSSI behavior becomes more pronounced under the interaction of multiple factors: women seem to be more significantly influenced by the external derivatives in the internal derivatives than male subjects, and are more likely to trigger NSSI behavior under the interaction of multiple factors. These findings effectively reveal the significant role of different end-influencing factors in NSSI behaviors at the level of gender differences, which can provide effective theoretical support to prevent and treat NSSI behaviors in adolescents.


Assuntos
Poder Familiar , Comportamento Autodestrutivo , Adolescente , Humanos , Masculino , Feminino , Estudos Transversais , Comportamento Autodestrutivo/epidemiologia , Adaptação Psicológica , Emoções
19.
Artigo em Inglês | MEDLINE | ID: mdl-36497669

RESUMO

Both insufficient sleep and self-injury are rising public health issues among middle school students. Understanding their relationship may guide the intervention and policy making to help youths gain a healthy life. Thus, we analysed the data collected from the Shanghai Students Health Risk Behavior Surveillance (2015) in the Huangpu District. Self-injury was self-reported and categorized into ever or never. Sleep duration was classified as sufficient and insufficient according to the Health China 2030 Plan and the National Sleep Foundation's updated sleep duration recommendations. Crude OR and adjusted OR of sleep duration and covariates were estimated for self-injury using the logistic regression models with standard error clustered on school types. Results showed that 8.42% of the participants had conducted self-injury, with girls more than boys and ordinary school students more than key school students. After full adjustment, sleep insufficiency increased the odds of conducting self-injury by approximately two folds (AOR = 2.08, 95%CI = 1.40-3.07). The odds of self-injury were higher among students studying at ordinary schools (AOR = 3.58, 95%CI = 1.25-10.27) or vocational schools (AOR = 2.00, 95%CI = 1.77-2.26), with comparison to those at key schools. Interventions seeking to solve insufficient sleep need to be multifaceted, with consideration of changing the school environment and multiple social contexts, which create stressful burdens for adolescents' development.


Assuntos
Comportamento Autodestrutivo , Privação do Sono , Adolescente , Masculino , Feminino , Humanos , Estudos Transversais , China/epidemiologia , Instituições Acadêmicas , Comportamento Autodestrutivo/epidemiologia , Sono
20.
Artigo em Inglês | MEDLINE | ID: mdl-36497828

RESUMO

OBJECTIVE: Hospital treated deliberate self-poisoning is common in young people. Internationally, estimates of rates of depression in this population are very wide (14.6% to 88%). The aims of this study were to determine the prevalence of depression and the independent predictors of referral for psychiatric hospitalisation in young people (aged 16 to 25 years) following an index episode of hospital treated deliberate self-poisoning. METHOD: A retrospective cohort study design (n = 1410), with data drawn from a population-based clinical case register. Unadjusted and adjusted estimates of predictors of referral for psychiatric admission (after-care) used logistic regression models. RESULTS: Prevalence of any depression diagnosis was 35.5% (n = 500); and 25.4% (n = 358) were referred for a psychiatric admission. The adjusted estimates for predictors of psychiatric inpatient referral were: high suicidal level (OR 118.21: CI 95% 63.23-220.99), low/moderate suicidal level (14.27: 9.38-21.72), any depression (2.88: 1.97-4.22), any psychosis (4.06; 1.15-14.36), older age (1.12: 1.04-1.21), and number of support people (0.88: 0.78-0.98). CONCLUSION: Depression was diagnosed in more than a third and was an independent predictor of psychiatric inpatient referral, so service providers need to account for this level of need in the provision of assessment and after-care services. Evidence-based guidelines for psychiatric inpatient after-care for deliberate self-poisoning and/or depression in young people are limited. Our explanatory model included suicidal level, depression, psychosis, older age, and available support persons, suggesting that the treating clinicians were making these discharge decisions for admission in keeping with those limited guidelines, although the balance of benefits and harms of psychiatric hospitalisation are not established. Future research examining patient experiences, effectiveness of psychiatric hospitalisation, and alternatives to hospitalisation is warranted.


Assuntos
Transtornos Psicóticos , Comportamento Autodestrutivo , Humanos , Adolescente , Hospitais Psiquiátricos , Estudos Retrospectivos , Austrália/epidemiologia , Hospitalização , Transtornos Psicóticos/terapia , Comportamento Autodestrutivo/epidemiologia , Comportamento Autodestrutivo/psicologia
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