Background

Non-suicidal self-injury (NSSI) is a highly prevalent behavioural problem among people with mental illness, yet many fundamental aspects of NSSI remain unknown. We studied the prevalence of NSSI, and its relationship with suicide ideation (SI) and suicide attempts (SA) among adult psychiatric outpatients, with a special focus on patients with personality disorders compared with patients with other disorders.

Method

During a 14-day period, data were collected on all available patients in all outpatient psychiatric clinics in Norway. This national clinical unselected cross-sectional dataset from 23,124 outpatients was used to generate proportional Venn diagrams of the prevalence of NSSI, SI and SA and their co-occurrence over the last four weeks. Differences in the risk for these behaviours across diagnoses were tested, both with and without adjustments for demographic and socio-demographic characteristics.

Results

Over the previous four-week period, 8.1% of the patients had experienced at least one episode of NSSI, 17.3% had SI and 0.6% had made at least one SA. Among patients with NSSI, 27.8% had co-occurring SI, and among patients with SI, 13% had co-occurring NSSI. The prevalence of SA was more than seven times higher among patients with NSSI behaviour than among patients without NSSI behaviour. Patients with a diagnosis of personality disorder had a significantly higher prevalence of SI, NSSI, and NSSI with co-occurring SI, than all other diagnostic groups; however, they were not systematically different from patients with other diagnoses in their prevalence of NSSI without co-occurring SI. These findings remained statistically significant even when controlling for socio-demographic variables.

Conclusions

The prevalence of recent NSSI is high in patients receiving outpatient psychiatric treatment in Norway. NSSI is significantly more prevalent in patients with personality disorders than in patients with other diagnoses, mainly due to the significantly higher prevalence of NSSI with co-occurring SI in patients with personality disorders. The co-occurrence of NSSI and SI is also prevalent in all diagnostic groups, but both NSSI and SI appear alone more often than together. The strong association between NSSI and SA calls for a more proactive focus on NSSI behaviour in mental health clinical settings as an important suicide preventive measure.

中文翻译：

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成人精神科门诊患者非自杀性自残（NSSI）–一项全国性研究

背景

非自杀性自残（NSSI）是精神疾病患者中非常普遍的行为问题，但NSSI的许多基本方面仍然未知。我们研究了成人精神病门诊患者中NSSI的患病率及其与自杀意念（SI）和自杀未遂（SA）的关系，特别着重于人格障碍患者与其他疾病患者的比较。

方法

在14天的时间内，收集了挪威所有门诊精神病诊所中所有可用患者的数据。从23,124位门诊患者那里获得的这个国家临床未选择的横截面数据集被用于生成NSSI，SI和SA的患病率及其在过去四周中同时发生的比例Venn图。在人口统计和社会人口特征调整的情况下和未进行调整的情况下，都测试了诊断过程中这些行为的风险差异。

结果

在过去的四周内，有8.1％的患者经历过至少1次NSSI发作，17.3％的患者患有SI和0.6％的患者至少经历了一次SA。在NSSI患者中，有27.8％的患者同时患有SI，而在SI患者中，有13％的患者同时患有NSSI。NSSI行为患者的SA患病率比无NSSI行为的患者高7倍以上。与所有其他诊断组相比，诊断为人格障碍的患者的SI，NSSI和NSSI并发SI患病率明显更高；但是，在没有同时发生SI的NSSI患病率方面，它们与其他诊断患者在系统上没有区别。即使控制社会人口统计学变量，这些发现仍具有统计学意义。

结论

在挪威，接受门诊精神病治疗的患者中最近的NSSI患病率很高。与患有其他疾病的患者相比，人格障碍患者中NSSI的患病率明显更高，这主要是由于在人格障碍患者中NSSI与并发SI的患病率明显更高。NSSI和SI的同时出现在所有诊断组中也很普遍，但是NSSI和SI出现的频率都比单独出现的高。NSSI与SA之间的紧密联系要求在精神卫生临床环境中更加积极地关注NSSI行为，将其作为重要的自杀预防措施。