A Comparison between Severe Suicidality and Nonsuicidal Self-Injury Behaviors in Bipolar Adolescents Referred to a Psychiatric Emergency Unit.

Stefano Berloffa,Annarita Milone,Ursula Madonia,Maria Mucci,Gabriele Masi,Giulia D’Acunto,Deborah Fabiani,Ilaria Lupetti,Francesca Lenzi

doi:10.3390/brainsci11060790

Stefano Berloffa, Annarita Milone + Show 7 more

Open Access

https://doi.org/10.3390/brainsci11060790

Copy DOI

Abstract

Background: Severe suicide ideation or attempts and non-suicidal self-injury (NSSI) present both differences and relevant overlaps, including frequent co-occurrence and shared risk factors. Specific categorical diagnoses, namely bipolar disorder (BD), may affect clinical features and natural histories of suicidal or not suicidal self-harm behaviour. Our study aimed to compare suicidality (severe suicidal ideation or suicidal attempts) and NSSI in referred bipolar adolescents. Methods: The sample included 95 bipolar adolescents (32 males, 63 females) aged 11 to 18 years. Thirty adolescents with suicide attempts/suicidal ideation and BD (SASIB) were compared with structured measures to 35 adolescents with NSSI and BD, without suicidal ideation or attempts (NSSIB), and to 30 adolescents with BD, without suicidal ideation or attempts or NSSI (CB). Results: Compared to CB, suicidality and NSSI were both associated with female sex, borderline personality disorder and self-reported internalizing disorders, anxiety/depression and thought disorders. The NSSI were specifically associated with somatic problems. Severe suicidal ideation and suicide attempts were associated with adverse life events, immigration, bullying, eating disorders, social problems, depressive feelings, performance and social anxiety, and feelings of rejection. Conclusions: Both shared and differential features between suicidal and not suicidal adolescents may represent possible targets for diagnostic and preventative interventions.

Highlights

Suicide is a global health problem, with at least 800,000 people dying by suicide each year; among 15–29 years old, it is the second leading cause of death [1]
There was a prevalence of females in the suicide attempts/suicidal ideation and BD (SASIB) (F/M 22/8) and NSSIB (F/M 29/6) groups, while there was a slight prevalence of males in the Control bipolar (CB) (F/M 12/18) (χ2 = 14.25, df = 2, p = 0.001)
About the frequency of the bipolar disorder (BD) types, there was a clear prevalence of BD II than BD I in the three groups (SASIB BD I/BD II 7/23, NSSIB BD I/BD II 4/31, CB BD I/BD II 6/24), and differences among groups were not statistically significant (χ2 = 1.69, df = 2, p = 0.429)

Summary

Introduction

Suicide is a global health problem, with at least 800,000 people dying by suicide each year; among 15–29 years old, it is the second leading cause of death [1]. Other important differences have been identified between suicide attempt and NSSI, including prevalence, frequency, lethality of methods, and attitudes towards life and death [5]. These differences led to the classification of NSSI and suicidal behavior as distinct clinical phenomena in the DSM-5 [3], the overlaps between self-harm with and without suicidal intent are relevant, including that many individuals engage in both behaviors [6]. Severe suicide ideation or attempts and non-suicidal self-injury (NSSI) present both differences and relevant overlaps, including frequent co-occurrence and shared risk factors. Conclusions: Both shared and differential features between suicidal and not suicidal adolescents may represent possible targets for diagnostic and preventative interventions

Objectives

Methods

Results

Discussion

Conclusion