Relationship between deliberate self-harm and suicidal behaviors in college students

Abstract

To describe the prevalence of deliberate self-harm (DSH) and suicidal behaviors (SIB) as well as the relationship between them in a college student population. A total of 4063 medical students were selected under the cluster sampling method in Anhui province. Data were analyzed by Pearson Chi-square and logistic regression. A total of 4063 (13.4%) students reported that they had deliberately harmed themselves during the past 12 months. The acts of DSH with 1 and more than or equal to 2 times occurrence accounted for 3.7% and 9.6% among all the respondents. The act of DSH was significantly higher among boys than that among girls. Rates of suicide ideation, suicide plan, attempted suicide and SIB in the last year were 4.5%, 1.4%, 0.6% and 4.9%, respectively. However no statistically significant difference was found in different sex. Students in the DSH group that with SIB were found to have lower positive coping levels (OR=0.5, 95%CI: 0.3-0.8), getting less support from friends (3-5 vs. less than or equal to 2: OR=0.6, 95%CI: 0.3-0.9; more than or equal to 6 vs. less than or equal to 2: OR=0.4, 95%CI: 0.2-0.8), with higher negative coping levels (OR=2.1, 95%CI: 1.2-3.7), having more serious depressive symptoms (OR=2.9, 95%CI: 1.6-5.2) and anxiety symptoms (OR=2.2, 95%CI: 1.2-3.8), having more serious sleeping problems (OR=1.7, 95%CI: 1.1-2.8) and perceived fat (fat vs. moderate: OR=2.0, 95%CI: 1.1-3.6) than the DSH group without SIB. The rates of SIB in students with DSH behavior were significantly higher than those in students without those behaviors (OR=4.7, 95%CI: 3.5-6.4). Psychosocial variables could attenuate the relationship between the DSH status and suicidal events (OR=3.3, 95%CI: 2.4-4.5). The DSH frequency exhibited a curvilinear relationship to SIB (OR=3.1-10.0) and psychosocial variables also attenuated this relationship (OR=2.4-5.9). It was well known that SIB was not a suicidal gesture but our findings suggested that the presence of DSH might trigger the suicidal attempts.