Differences in risk factors for self-harm with and without suicidal intent: findings from the ALSPAC cohort.
Differences in risk factors for self-harm with and without suicidal intent: findings from the ALSPAC cohort.
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DOI：
10.1016/j.jad.2014.07.009
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发表时间：
2014-10
影响因子：
6.6
通讯作者：
Gunnell D
中科院分区：
文献类型：
--
作者：
Mars B;Heron J;Crane C;Hawton K;Kidger J;Lewis G;Macleod J;Tilling K;Gunnell D
有自杀意图的自残在病因和预后上是否与非自杀性自残不同，以及它们是否应被视为不同的诊断类别，目前尚缺乏共识。参与者是雅芳父母和孩子纵向研究(ALSPAC)的4799名成员，这是一个以英国人口为基础的出生队列，他们在16岁时完成了一份关于有和没有自杀意图的自我伤害的邮寄问卷。多项Logistic回归分析被用来检验有和没有自杀意图自我伤害的个体在危险因素方面的差异。这两种行为都有许多共同的风险因素，但与自杀自残的联系通常更强。精神健康问题尤其如此；与那些没有自杀倾向的人相比，那些有自杀意图的人患抑郁症(OR 3.50[95%CI 1.64，7.43])和焦虑症(OR 3.50[95%CI 1.72，7.13])的风险更高。高智商和母亲文化程度是非自杀性自残的危险因素，但不是自杀性自残的危险因素。自杀自残的特有危险因素包括低智商和社会经济地位、家庭中对儿童的身体虐待和父母的自残。I)有一些需要追踪的损失，ii)难以衡量自杀意向，iii)我们不能排除某些暴露变量存在反向因果关系的可能性，iv)我们无法确定仅因自杀意图而受到伤害的亚组。有和没有自杀意图的自我伤害是重叠的行为，但具有一些明显的特征，表明充分探索自残青少年的易受伤害因素、动机和意图的重要性。
There is a lack of consensus about whether self-harm with suicidal intent differs in aetiology and prognosis from non-suicidal self-harm, and whether they should be considered as different diagnostic categories. Participants were 4799 members of the Avon Longitudinal Study of Parents and Children (ALSPAC), a UK population-based birth cohort who completed a postal questionnaire on self-harm with and without suicidal intent at age 16 years. Multinomial logistic regression analyses were used to examine differences in the risk factor profiles of individuals who self-harmed with and without suicidal intent. Many risk factors were common to both behaviours, but associations were generally stronger in relation to suicidal self-harm. This was particularly true for mental health problems; compared to those with non-suicidal self-harm, those who had harmed with suicidal intent had an increased risk of depression (OR 3.50[95% CI 1.64, 7.43]) and anxiety disorder (OR 3.50[95% CI 1.72, 7.13]). Higher IQ and maternal education were risk factors for non-suicidal self-harm but not suicidal self-harm. Risk factors that appeared specific to suicidal self-harm included lower IQ and socioeconomic position, physical cruelty to children in the household and parental self-harm. i) There was some loss to follow-up, ii) difficulty in measuring suicidal intent, iii) we cannot rule out the possibility of reverse causation for some exposure variables, iv) we were unable to identify the subgroup that had only ever harmed with suicidal intent. Self-harm with and without suicidal intent are overlapping behaviours but with some distinct characteristics, indicating the importance of fully exploring vulnerability factors, motivations, and intentions in adolescents who self harm.
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