Abstract
Non-suicidal self-injury (NSSI) in adolescents hospitalized with psychiatric disorders continues to increase after the outbreak of COVID-19. This study aimed to explore the relationship between the pandemic and NSSI among adolescents and whether the composition of psychosocial factors related to NSSI has changed during the pandemic. Through the retrospective analysis of medical records retrieved from the electronic system of the psychiatric hospital located in Chengdu from January 2016 to March 2021, 609 medical records of adolescents were obtained. The main potential psychosocial factors were determined by deductive content analysis. Among the 609 adolescents, 420 subjects had engaged in NSSI, while 189 did not. We found that the percentage of adolescents who had engaged in NSSI in 2016 was only 29.2%, reaching 34.5% in 2017, 45.7% in 2018, 61.3% in 2019, 92.5% in 2020, and 95.9% in 2021. In the binary logistic regression model, female sex (OR = 0.073, 95% CI: 0.028–0.186), older age (OR = 1.234, 95% CI: 1.030–1.478), having a single parent (OR = 7.865, 95% CI: 3.997–15.476), having experienced trauma (OR = 2.192, 95% CI: 1.032–4.654), having experienced social isolation from peers (OR = 8.139, 95% CI: 4.037–16.408), having experienced body-focused bullying (OR = 3.078, 95% CI: 1.295–7.318), overuse of a mobile phone in the parents' opinions (OR = 4.354, 95% CI: 1.380–13.738), having attempted suicide (OR = 9.120, 95% CI: 4.492–18.512), and during the pandemic (time point is January 30, 2020) (OR = 5.399, 95% CI: 1.679–17.357) were the factors that were significantly associated with NSSI. When comparing the differences in psychosocial factors between the pre-pandemic and the during-pandemic groups, the results showed that the family constitution, parent–child relationships, mobile phone overuse, and stressful learning were important factors. Tailored interventions geared towards changed psychosocial factors should be formulated.
Highlights
Non-suicidal self-injury (NSSI) refers to the behaviour of directly damaging one’s body tissue, such as self-harming, skin scratching, and self-burning [1]
We found that after the outbreak of COVID-19, the number of adolescents with NSSI behaviours admitted to the hospital increased, and their average age was younger, while their duration of disorder was longer, which means that the seriousness and difficulty of the problem increased
When analysing the influencing factors of NSSI in all adolescents admitted to our hospital, we found that females were more prone to engage in NSSI behaviours, which is consistent with findings from previous studies on NSSI behaviours in adolescents [31, 32]
Summary
NSSI (non-suicidal self-injury) refers to the behaviour of directly damaging one’s body tissue, such as self-harming, skin scratching, and self-burning [1]. The purpose of implementing this behaviour is not to cause death, but many related studies have found that the suicide risk of patients who engage in NSSI is hundreds of times higher than that of the general. Other risk factors for NSSI might focus on psychosocial factors, including dysfunctional relationships [8], being bullied by peers [9], and being mistreated by parents [10]. The COVID-19 pandemic is a strong stressor for adolescents, which might further increase their NSSI prevalence, like the experience reported by Hasking et al, [19]. It can be demonstrated by the findings in the research by Ougrin et al, that the pandemic-related emergency psychiatric presentations of NSSI for children and adolescents increased from 50% in 2019 to 57% during the COVID-19 lockdown in 2020 [20]
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