An Exploration of Differences Between Deliberate Self-Harm with and without Suicidal Intent Amongst a Clinical Sample of Young People in Singapore: A Cross-Sectional Study.

Ellaisha Samari,Mythily Subramaniam,Siow Ann Chong,Edimansyah Abdin,Rajeswari Sambasivam,Shazana Shahwan,Wen Lin Teh,Yunjue Zhang,Say How Ong

doi:10.3390/ijerph17041429

Ellaisha Samari, Mythily Subramaniam + Show 7 more

Open Access

https://doi.org/10.3390/ijerph17041429

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Abstract

This study examined differences between young people with mental illness who engage in deliberate self-harm with and without suicidal intent, as well as socio-demographic and clinical factors that are related to the increased likelihood of suicide attempt amongst self-harming young people. A total of 235 outpatients with mental illness who had engaged in deliberate self-harm were recruited from a tertiary psychiatric hospital in Singapore. Participants completed a self-report questionnaire which collected information on their socio-demographic background, self-harm history, diagnosis, depressive symptoms and childhood trauma. A total of 31.1% had reported a history of attempted suicide. Multiple logistic regression conducted found that engaging in self-harm ideation between 1 and 7 days (OR = 4.3, p = 0.30), and more than 1 week (OR = 10.5, p < 0.001) (versus no engagement in any self-harm ideation at all), were significantly associated with greater likelihood of attempted suicide. This study reports a relatively high prevalence rate of reported suicide attempts amongst young people with mental illness who engaged in self-harm. Identifying self-harm behaviors and treating it early could be the first step in managing potential suicidal behaviors among those who engage in self-harm.

Highlights

Self-injurious behaviors refer to a broad category of behaviors that result in direct and deliberate harm of one’s own body, that typically peaks during adolescent years [1,2]
The present study explored socio-demographic and clinical differences between a clinical sample of young people who had engaged in deliberate self-harm without suicidal intent (DSH w/o SI) and those who had engaged in deliberate self-harm with suicidal intent (DSH w/SI)
This study reports a relatively high prevalence rate of reported suicide attempts amongst young people with mental illness who engaged in self-harm and highlights the differences between those who engaged in self-harm with and without suicidal intent

Summary

Introduction

Self-injurious behaviors refer to a broad category of behaviors that result in direct and deliberate harm of one’s own body, that typically peaks during adolescent years [1,2]. A complex issue in this field of research is the use of various nomenclature in the literature with definitions differing based on the extent to which the behavior includes suicidal or non-suicidal intent. Comparing prevalence across studies and countries becomes challenging. Existing literature suggests that a significant number of young people worldwide engage in self-injurious behaviors. Muehlenkamp et al [3] conducted a systematic review across studies of adolescent samples and found a mean lifetime prevalence of 18.0% for non-suicidal. Res. Public Health 2020, 17, 1429; doi:10.3390/ijerph17041429 www.mdpi.com/journal/ijerph

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