Nonsuicidal self-injury in a naturalistic sample of adolescents undergoing inpatient psychiatric treatment: prevalence, gender distribution and comorbidities.

ABSTRACT

BACKGROUND: A growing body of research points toward nonsuicidal self-injury (NSSI) in adolescents as an important and frequent health-related risk factor. In 2013, NSSI was proposed in section 3 of the DSM-5 as a new diagnostic entity warranting further study. In line with that goal, the present study was conducted in order to evaluate prevalence, gender distribution and comorbidities of NSSI in a sample of adolescent psychiatric inpatients. SUBJECTS AND METHODS: The study included 130 adolescents (mean age 15.09 years, SD ± 1.47; 71.5% female) undergoing inpatient psychiatric treatment at a specialized facility. The factors assessed were sociodemographic data, the presence of NSSI according to the proposed DSM-5 criteria, clinical psychiatric diagnosis, the presence of suicidality and the presence of personality disorder. RESULTS: A large percentage, 38.5%, of the sample fulfilled DSM-5 criteria for NSSI, and more than half (50.8%) of the adolescents indicated having injured themselves at least once in the past. Patients with NSSI were predominantly young women and clustered in a spectrum of diagnostic entities including not only borderline personality disorders but also substance use disorders and affective disorders. A strong association was found between suicidality (suicidal ideation, history of suicide attempt) and NSSI. CONCLUSIONS: In line with previous findings, NSSI among adolescent psychiatric inpatients was found to be a frequent phenomenon associated with a broad spectrum of comorbidities. Moreover, while NSSI is conceptualized as an act without suicidal intent, it commonly occurs in patient groups with suicidal ideation or with a history of suicide attempts.