Risk Factors for Non-Suicidal Self-Injury (NSSI) in Adolescents: A Meta-Analysis

Abstract

Background: Non-suicidal self-injury (NSSI) in adolescents has become a prevalent mental health problem around the world. The mechanism of NSSI is still complex. Here we performed a meta-analysis on recent studies to systematically delineate the risk factors for NSSI. Method: We searched Medline, Embase, Web of Science and Cochrane for relevant articles and abstracts published through June,12 2021. Pooled odds ratio (OR) and 95% confident intervals (CIs) were used to assess various risk factors and the publication bias were assessed by funnel plot, Egger test and trim and fill method. This study is registered with PROSPERO, CRD42021265885. Results: A total of 22 articles were eventually included for the analysis. Seventy risk factors were identified and classified into 8 categories. Pooled ORs of bullying, mental disorder, low health literacy, sleep problems, problem behaviors, adverse childhood experiences, female and physical symptoms were 1.85 (1.26-2.70), 2.01 (1.26-2.70), 2.22 (0.96-5.17), 2.55 (1.96-3.32), 2.61 (1.89-3.60), 2.98 (2.37-3.74) and 4.16 (0.96-18.08), respectively. The range of heterogeneous (I2) were from 41.0% to 99.3%. Conclusion: The present analysis demonstrated that the mental disorder, low health literacy, adverse childhood experiences, bullying, problem behaviors and female are relevant risk factors for NSSI. Registration Details: This study is registered with PROSPERO, CRD42021265885. Funding Information: NSFC grant (81822017, 31771215), National Key R&D Program of China (2020YFA0113600), Natural Science Foundation of Zhejiang Province, China (No. LY19H090015), Medicine and Engineering Interdisciplinary Research Fund of Shanghai Jiao Tong University (ZH2018ZDA30), Shenzhen-Hong Kong Institute of Brain Science - Shenzhen Fundamental Research Institutions (NYKFKT20190020), Shanghai Municipal Education Commission - Gaofeng Clinical Medicine Grant Support (20181715). We also thank the support from the Innovative Research Team of High-level Local Universities in Shanghai. Declaration of Interests: All authors declare no competing interests.