Abstract
Background: The aims of this study were to determine the prevalence of deliberate self-harm (DSH) and to compare the risk of self-harm in Chinese children with different types and severity of disabilities. Methods: Participants were 1300 children aged 6–17 years in Beijing, China; 650 children with disabilities and 650 healthy peers matched on age, gender and residence district. Questionnaires were completed anonymously by parents or children if the age or disability made it necessary. The associations between the disability type, severity and DSH were examined using the Chi-square testing and logistic regression models. Results: Children with a single disability or multiple disabilities had statistically higher rates of DSH than children without disabilities (15.6% and 39.7% compared to 10.9%). The prevalence of DSH was associated with the severity of disability, being 36.2% among children with level 1 (the most severe) disability, 19.8% among children with level 2 disability, and 9.2% among children with level 3 + 4 disability. The multivariable odds ratio (OR) of DSH among children with any disability was statistically higher than that among children without a disability (OR = 2.40; 95% CI = 1.71, 3.36; p < 0.05). Children with multiple disabilities (OR = 6.89; 95% CI: 4.24–11.20) and level 1 severity of disability (OR = 6.11; 95% CI: 3.91–9.56) had the highest risk of DSH. Conclusions: This study clearly demonstrated associations between the severity and type of disability and DSH. This finding highlights the importance of DSH in children with disabilities, and underlines the importance of the prevention of DSH among a vulnerable pediatric population in China.
Highlights
Deliberate self-harm (DSH) is a major public health problem around the world, with approximately3% of the total disease burden among people 10–24 years old attributable to self-harm behaviors [1].The estimated number of individuals who engage in self-injury will be 15–30 million annually by [2]
For every participating child with disabilities, we matched a child without disabilities who had the same age and gender, and who lived in the same district
This study demonstrated a clear association between the disability type, severity and deliberate self-harm (DSH) risk in this vulnerable Chinese pediatric population
Summary
Deliberate self-harm (DSH) is a major public health problem around the world, with approximately3% of the total disease burden among people 10–24 years old attributable to self-harm behaviors [1].The estimated number of individuals who engage in self-injury will be 15–30 million annually by [2]. Children with disabilities have long-term physical, mental, intellectual or sensory impairments that may reduce their ability to conduct activities and social functions, and increases their risk of injury [9,10,11,12]. Due to their varying disability types and functional levels, children with disabilities have differential injury risks [10,11]. The aims of this study were to determine the prevalence of deliberate self-harm (DSH) and to compare the risk of self-harm in Chinese children with different types and severity of disabilities. The prevalence of DSH was associated with the severity of disability, being 36.2% among children with level 1 (the most severe) disability, 19.8% among children with level 2 disability, and 9.2%
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