BACKGROUND For children and adolescents,deliberate self-harm(DSH)is becoming a mental health problem of concern.Despite several studies on the prevalence and factors of DSH in the world,there is little information on ...BACKGROUND For children and adolescents,deliberate self-harm(DSH)is becoming a mental health problem of concern.Despite several studies on the prevalence and factors of DSH in the world,there is little information on DSH among children and adolescents in China.This study explores the prevalence,types,associated risk factors and tendency of DSH in pediatric psychiatric inpatients in China.AIM To understand the situation of DSH among hospitalized children and adolescents and its related factors.METHODS In this study,we retrospectively studied 1414 hospitalized children and adolescents with mental illness at Xiamen Mental Health Center from 2014 to 2019,extracted the demographic and clinical data of all patients,and analyzed clinical risk factors of DSH.RESULTS A total of 239(16.90%)patients engaged in at least one type of DSH in our study.Cutting(n=115,48.12%)was the most common type of DSH.Females(n=171,71.55%)were more likely to engage in DSH than males(n=68,28.45%).DSH was positively associated with depressive disorders[OR=3.845(2.196-6.732);P<0.01],female[OR=2.536(1.815-3.542);P<0.01],parental marital status[OR=5.387(2.254-12.875);P<0.01]and negative family history of psychiatric illness[OR=7.767(2.952-20.433);P<0.01],but not with occupation,substance use and history of physical abuse.CONCLUSION Our findings suggest that for patients with depression,females,an abnormal marriage of parents,and no history of mental illness,attention should be paid to the occurrence of DSH.展开更多
BACKGROUND Recently,a growing number of adolescents have been afflicted with mental disorders,with annual morbidity rates on the rise.This trend has been exacerbated by the global coronavirus disease 2019(COVID-19)pan...BACKGROUND Recently,a growing number of adolescents have been afflicted with mental disorders,with annual morbidity rates on the rise.This trend has been exacerbated by the global coronavirus disease 2019(COVID-19)pandemic,leading to a surge in suicide and self-harm rates among this demographic.AIM To investigate the impact of the COVID-19 pandemic on adolescent bipolar disorder(BD),along with the underlying factors contributing to heightened rates of suicide and self-harm among adolescents.METHODS A comprehensive statistical analysis was conducted utilizing clinical interviews and self-reports obtained from patients or their guardians.Diagnostic criteria for BDs were based on the Diagnostic and statistical manual of mental disorders,international classification of diseases-11,and the National institute of mental health research domain criteria.Statistical analyses were performed using SPSS 26.0 software,with significance set at P<0.05.RESULTS A cohort of 171 adolescents diagnosed with BD between January 1,2018,and December 31,2022,was included in the analysis.The gender distribution was 2.8:1(female to male),with ages ranging from 11 to 18 years old.Major factors contributing to adolescent BDs included familial influences,academic stress,genetic predisposition and exposure to school-related violence.Notably,a significant increase in suicide attempts and self-harm incidents was observed among adolescents with BD during the COVID-19 pandemic.Statistical analysis indicated that the pandemic exacerbated familial discord and heightened academic stress,thereby amplifying the prevalence of suicidal behavior and self-harm among adolescents.CONCLUSION The COVID-19 pandemic has exacerbated familial tensions and intensified the incidence of suicide and self-harm among adolescents diagnosed with BD.This study underscores the urgent need for societal,familial and educational support systems to prioritize the well-being of adolescents and offers valuable insights and guidelines for the prevention,diagnosis and treatment of adolescent BDs.展开更多
Introduction: Sickle cell anaemia is a hereditary disease that combines physical and psychological manifestations, including suicidal tendencies. So far, to our knowledge, no study has been conducted on suicidal behav...Introduction: Sickle cell anaemia is a hereditary disease that combines physical and psychological manifestations, including suicidal tendencies. So far, to our knowledge, no study has been conducted on suicidal behaviours among people with sickle cell disease in Cameroon. This is what justifies our study on the prevalence and factors related to suicidal behaviors in our study population. Methods: We conducted a cross-sectional, analytical study of 171 sickle cell patients aged from 12 years upwards who came to the sickle cell disease care service of the Laquintinie Hospital in Douala, over a period of 6 months, that is, from 1 January to 31 June 2022. Data were collected using a structured questionnaire with questions on suicidal behaviours based on the “MINI” (Mini International Neuropsychiatric Interview). The data were processed using the SPSS 26.0 software. The related factors were studied in both a bivariate and multivariate analysis. Results: Female sickle cell patients accounted for 60.2% of the sample. The mean age was 23.36 ± 8.42 years. Suicidal ideation was prevalent in 56% of cases and 13% attempted suicide. The factors most associated with suicidal ideation were: primary level of education (OR = 0.08 (0.09 - 0.79);p = 0.03), feeling unworthy of life (OR = 0.40 (0.08 - 1.96);p = 0.02), not often being considered by those around them (OR = 2.97 (1.26 - 6.99);p = 0.01), lack of family support (OR = 0.34 (0.15 - 0.77);p = 0.01). Meanwhile, the factors associated with suicide attempts were: the fact of being rarely exposed to suicide-related media (OR = 4.17 (1.40 - 71.80);p = 0.03), and a constant feeling of sadness when returning home (OR = 18.02 (1.59 - 20.55);p = 0.01). Conclusion: More than half of sickle cell patients had had suicidal thoughts and 1/6 had made at least one suicide attempt, women and young adults being the most concerned. It is therefore necessary to ensure optimum psychological care for patients with sickle cell disease.展开更多
BACKGROUND Previous studies have shown that personality traits are associated with self-harm(SH)in adolescents.However,the role of resilience in this association remains unclear.Our research aims to explore the hypoth...BACKGROUND Previous studies have shown that personality traits are associated with self-harm(SH)in adolescents.However,the role of resilience in this association remains unclear.Our research aims to explore the hypothesized mediation effect of resilience in the relationship between personality traits and SH in Chinese children and adolescents.AIM To evaluate resilience as a mediator of the association between personality traits and SH.METHODS A population-based cross-sectional survey involving 4471 children and adolescents in Yunnan province in southwestern China was carried out.Relevant data were collected by self-reporting questionnaires.Univariate and multivariate logistic regression models were employed to identify associated factors of SH.A path model was used to assess the mediation effect of resilience with respect to personality traits and SH association.RESULTS Among the 4471 subjects,1795 reported SH,with a prevalence of 40.1%(95%CI:34.4%-46.0%).All dimensions of personality traits were significantly associated with SH prevalence.Resilience significantly mediated the associations between three dimensions of personality(extroversion,neuroticism,psychoticism)and SH,accounting for 21.5%,4.53%,and 9.65%,respectively,of the total associations.Among all dimensions of resilience,only emotional regulation played a significant mediation role.CONCLUSION The results of the study suggest that improving emotion regulation ability might be effective in preventing personality-associated SH among Chinese children and adolescents.展开更多
<strong>Background: </strong>There is no extensive literature on social predictors of self-harm in the juvenile justice system, over the time of a prisoner’s sentence. Self-harm behavior displays a higher...<strong>Background: </strong>There is no extensive literature on social predictors of self-harm in the juvenile justice system, over the time of a prisoner’s sentence. Self-harm behavior displays a higher prevalence in prison, 11 to 14 times greater than in the general population. Our study extended the current research in self-harm by examining dynamic factors of self-harm in adolescents over their sentence in the Romanian juvenile prison system. <strong>Method: </strong>The present research examined longitudinal predictors of self-harm behaviors in 439 adolescent inmates (Mage = 16.21;5.2% female, 94.8% male), enrolled in prison during 2011-2012, following them for two years. A series of time-to-event analyses were applied to start from the time of the subject’s internment in the juvenile prison system. <strong>Results:</strong> Findings from the multivariate survival analyses show that adherence to self-harm conduct in prison was consistently influenced by family factors and prison contexts;although low ability to cope with frustration, sensitivity and emotion dysregulation also mattered. Keeping the other covariates invariant, serving a prison sentence in a closed regime reduces the probability of remaining free of self-harm events, increasing the monthly hazard of self-harm by a factor of 5.26 on average (HR = 5.26, 95% CI = 2.37 - 11.64) compared to the open regime. <strong>Conclusion:</strong> A greater focus on longitudinal studies may help improve the screening process and also follow the progress of each juvenile to warrant the efficacy of preventive programs in self-harm, according to their emerging needs.展开更多
Cutting or self inflicted epidermal damage (derma-abuse) describes a number of blood- letting behaviours among adolescents. Unlike suicidal behaviour, it is associated with low lethality and the absence of suicidal at...Cutting or self inflicted epidermal damage (derma-abuse) describes a number of blood- letting behaviours among adolescents. Unlike suicidal behaviour, it is associated with low lethality and the absence of suicidal attempts. The purpose of this study is two-fold: Firstly, to present and discuss vignettes of four young adolescents and secondly, to study the dynamics and characteristics of six derma-abusers who have attended Dual Group Therapy (DGT) concurrently with their parents for a six month period. Our findings suggest that patients involved in derma-abuse are generally non-suicidal but engage in comfort cutting for the psychological release of pain, tension reduction and anger management. There is a preponderance of females (80%) with an over-representation of mixed origin and borderline cultural states. In this small group, males amounted to 20% and were more bizarre, gruesome and brutal in their self-abuse. Of the total sample, 10% were of African origin, 60% were of Indian descent and 30% were of mixed ancestry. Psy- chodynamic factors explored in Dual Group Therapy (DGT) are the emphasis on non-suicidal intent, association with tension reduction, reclaiming power and mastery over self and others, life and death instincts, the significance of bloodletting in a socio-cultural context, trans- generational conflicts, dysfunctional family dynamics frequently with parental separation and sexual abuse and early sexual induction.展开更多
Background:A number of studies report high prevalence of mental health conditions among burn patients. However there is a need to understand differences in the temporal relationship between mental health conditions an...Background:A number of studies report high prevalence of mental health conditions among burn patients. However there is a need to understand differences in the temporal relationship between mental health conditions and intentional and unintentional burns to hasten psychological prevention and intervention. This study aims to compare the socio-demographic profile, burn characteristics and pre-and post-burn psychiatric morbidity of burn patients by intent-of-injury. Methods:De-identified linked hospital, death and mental health (MH) case registry data of burn patients hospitalised in Western Australia between 1 January 1980 and 30 June 2012 were analysed. Crude (observed) post-burn rates of mental health admissions were generated by burn intent-of-injury. Descriptive statistics were performed to compare the characteristics of the burn patients. Results:A total of 30,997 individuals were hospitalised for a first burn;360 (1.2%) had self-harm burns and 206 (0.7%) assault burns. Over the study period, admission rates for assault burns increased by 4.8%per year (95%confidence interval (CI) 3.1–6.5%) and self-harm burns increased 6.9%per year (95%CI 4.8–9.1%). Self-harm and assault burns occurred mainly among those aged 15 to 44 years (median age, interquartile range (IQR):self-harm 30 years, 22–40;assault 31 years, 23–38). Those with self-harm burns had a longer index hospital stay (median (IQR):self-harm 15 days (5–35) vs 4 days (1–11) assault vs 4 days (1–10) unintentional) and higher in-hospital mortality (7.2%self-harm vs 1.9%assault burns vs 0.8%unintentional). More than half (55.0%) of self-harm burns had a prior hospitalisation (5-year lookback) for a MH condition vs 10.7%of assault burns and 2.8%of unintentional burns. Crude post-burn rates of MH admissions per 100 person-years (PY) by intent-of-burn subgroups:self-harm 209 per 100 PY, assault burns 11 per 100 PY and unintentional burns 3 per 100 PY. Conclusions:Intentional burn patients experienced significantly higher pre-and post-burn mental health morbidity along with significant adverse outcome in comparison with unintentional burns. Early psychological assessment and intervention could help in improving the MH of these patients.展开更多
基金Supported by Shenzhen Fund for Guangdong Provincial High-level Clinical Key Specialties,No.SZGSP013Shenzhen Key Medical Discipline Construction Fund,No.SZXK042+2 种基金Sanming Project of Medicine in Shenzhen,No.SZSM202311025Natural Science Fund of Fujian Province,No.2023J011622Natural Science Fund of Xiamen City,No.3502Z20224ZD1259.
文摘BACKGROUND For children and adolescents,deliberate self-harm(DSH)is becoming a mental health problem of concern.Despite several studies on the prevalence and factors of DSH in the world,there is little information on DSH among children and adolescents in China.This study explores the prevalence,types,associated risk factors and tendency of DSH in pediatric psychiatric inpatients in China.AIM To understand the situation of DSH among hospitalized children and adolescents and its related factors.METHODS In this study,we retrospectively studied 1414 hospitalized children and adolescents with mental illness at Xiamen Mental Health Center from 2014 to 2019,extracted the demographic and clinical data of all patients,and analyzed clinical risk factors of DSH.RESULTS A total of 239(16.90%)patients engaged in at least one type of DSH in our study.Cutting(n=115,48.12%)was the most common type of DSH.Females(n=171,71.55%)were more likely to engage in DSH than males(n=68,28.45%).DSH was positively associated with depressive disorders[OR=3.845(2.196-6.732);P<0.01],female[OR=2.536(1.815-3.542);P<0.01],parental marital status[OR=5.387(2.254-12.875);P<0.01]and negative family history of psychiatric illness[OR=7.767(2.952-20.433);P<0.01],but not with occupation,substance use and history of physical abuse.CONCLUSION Our findings suggest that for patients with depression,females,an abnormal marriage of parents,and no history of mental illness,attention should be paid to the occurrence of DSH.
基金Local Special Projects in Major Health of Hubei Provincial Science and Technology Department,No.2022BCE054Key Scientific Research Projects of Hubei Polytechnic University,No.23xjz08A.
文摘BACKGROUND Recently,a growing number of adolescents have been afflicted with mental disorders,with annual morbidity rates on the rise.This trend has been exacerbated by the global coronavirus disease 2019(COVID-19)pandemic,leading to a surge in suicide and self-harm rates among this demographic.AIM To investigate the impact of the COVID-19 pandemic on adolescent bipolar disorder(BD),along with the underlying factors contributing to heightened rates of suicide and self-harm among adolescents.METHODS A comprehensive statistical analysis was conducted utilizing clinical interviews and self-reports obtained from patients or their guardians.Diagnostic criteria for BDs were based on the Diagnostic and statistical manual of mental disorders,international classification of diseases-11,and the National institute of mental health research domain criteria.Statistical analyses were performed using SPSS 26.0 software,with significance set at P<0.05.RESULTS A cohort of 171 adolescents diagnosed with BD between January 1,2018,and December 31,2022,was included in the analysis.The gender distribution was 2.8:1(female to male),with ages ranging from 11 to 18 years old.Major factors contributing to adolescent BDs included familial influences,academic stress,genetic predisposition and exposure to school-related violence.Notably,a significant increase in suicide attempts and self-harm incidents was observed among adolescents with BD during the COVID-19 pandemic.Statistical analysis indicated that the pandemic exacerbated familial discord and heightened academic stress,thereby amplifying the prevalence of suicidal behavior and self-harm among adolescents.CONCLUSION The COVID-19 pandemic has exacerbated familial tensions and intensified the incidence of suicide and self-harm among adolescents diagnosed with BD.This study underscores the urgent need for societal,familial and educational support systems to prioritize the well-being of adolescents and offers valuable insights and guidelines for the prevention,diagnosis and treatment of adolescent BDs.
文摘Introduction: Sickle cell anaemia is a hereditary disease that combines physical and psychological manifestations, including suicidal tendencies. So far, to our knowledge, no study has been conducted on suicidal behaviours among people with sickle cell disease in Cameroon. This is what justifies our study on the prevalence and factors related to suicidal behaviors in our study population. Methods: We conducted a cross-sectional, analytical study of 171 sickle cell patients aged from 12 years upwards who came to the sickle cell disease care service of the Laquintinie Hospital in Douala, over a period of 6 months, that is, from 1 January to 31 June 2022. Data were collected using a structured questionnaire with questions on suicidal behaviours based on the “MINI” (Mini International Neuropsychiatric Interview). The data were processed using the SPSS 26.0 software. The related factors were studied in both a bivariate and multivariate analysis. Results: Female sickle cell patients accounted for 60.2% of the sample. The mean age was 23.36 ± 8.42 years. Suicidal ideation was prevalent in 56% of cases and 13% attempted suicide. The factors most associated with suicidal ideation were: primary level of education (OR = 0.08 (0.09 - 0.79);p = 0.03), feeling unworthy of life (OR = 0.40 (0.08 - 1.96);p = 0.02), not often being considered by those around them (OR = 2.97 (1.26 - 6.99);p = 0.01), lack of family support (OR = 0.34 (0.15 - 0.77);p = 0.01). Meanwhile, the factors associated with suicide attempts were: the fact of being rarely exposed to suicide-related media (OR = 4.17 (1.40 - 71.80);p = 0.03), and a constant feeling of sadness when returning home (OR = 18.02 (1.59 - 20.55);p = 0.01). Conclusion: More than half of sickle cell patients had had suicidal thoughts and 1/6 had made at least one suicide attempt, women and young adults being the most concerned. It is therefore necessary to ensure optimum psychological care for patients with sickle cell disease.
基金Supported by National Natural Science Foundation of China,No. 82060601Top Young Talents of Yunnan Ten Thousand Talents Plan,No. YNWR-QNBJ-2018-286the Innovative Research Team of Yunnan Province,No. 202005AE160002
文摘BACKGROUND Previous studies have shown that personality traits are associated with self-harm(SH)in adolescents.However,the role of resilience in this association remains unclear.Our research aims to explore the hypothesized mediation effect of resilience in the relationship between personality traits and SH in Chinese children and adolescents.AIM To evaluate resilience as a mediator of the association between personality traits and SH.METHODS A population-based cross-sectional survey involving 4471 children and adolescents in Yunnan province in southwestern China was carried out.Relevant data were collected by self-reporting questionnaires.Univariate and multivariate logistic regression models were employed to identify associated factors of SH.A path model was used to assess the mediation effect of resilience with respect to personality traits and SH association.RESULTS Among the 4471 subjects,1795 reported SH,with a prevalence of 40.1%(95%CI:34.4%-46.0%).All dimensions of personality traits were significantly associated with SH prevalence.Resilience significantly mediated the associations between three dimensions of personality(extroversion,neuroticism,psychoticism)and SH,accounting for 21.5%,4.53%,and 9.65%,respectively,of the total associations.Among all dimensions of resilience,only emotional regulation played a significant mediation role.CONCLUSION The results of the study suggest that improving emotion regulation ability might be effective in preventing personality-associated SH among Chinese children and adolescents.
文摘<strong>Background: </strong>There is no extensive literature on social predictors of self-harm in the juvenile justice system, over the time of a prisoner’s sentence. Self-harm behavior displays a higher prevalence in prison, 11 to 14 times greater than in the general population. Our study extended the current research in self-harm by examining dynamic factors of self-harm in adolescents over their sentence in the Romanian juvenile prison system. <strong>Method: </strong>The present research examined longitudinal predictors of self-harm behaviors in 439 adolescent inmates (Mage = 16.21;5.2% female, 94.8% male), enrolled in prison during 2011-2012, following them for two years. A series of time-to-event analyses were applied to start from the time of the subject’s internment in the juvenile prison system. <strong>Results:</strong> Findings from the multivariate survival analyses show that adherence to self-harm conduct in prison was consistently influenced by family factors and prison contexts;although low ability to cope with frustration, sensitivity and emotion dysregulation also mattered. Keeping the other covariates invariant, serving a prison sentence in a closed regime reduces the probability of remaining free of self-harm events, increasing the monthly hazard of self-harm by a factor of 5.26 on average (HR = 5.26, 95% CI = 2.37 - 11.64) compared to the open regime. <strong>Conclusion:</strong> A greater focus on longitudinal studies may help improve the screening process and also follow the progress of each juvenile to warrant the efficacy of preventive programs in self-harm, according to their emerging needs.
文摘Cutting or self inflicted epidermal damage (derma-abuse) describes a number of blood- letting behaviours among adolescents. Unlike suicidal behaviour, it is associated with low lethality and the absence of suicidal attempts. The purpose of this study is two-fold: Firstly, to present and discuss vignettes of four young adolescents and secondly, to study the dynamics and characteristics of six derma-abusers who have attended Dual Group Therapy (DGT) concurrently with their parents for a six month period. Our findings suggest that patients involved in derma-abuse are generally non-suicidal but engage in comfort cutting for the psychological release of pain, tension reduction and anger management. There is a preponderance of females (80%) with an over-representation of mixed origin and borderline cultural states. In this small group, males amounted to 20% and were more bizarre, gruesome and brutal in their self-abuse. Of the total sample, 10% were of African origin, 60% were of Indian descent and 30% were of mixed ancestry. Psy- chodynamic factors explored in Dual Group Therapy (DGT) are the emphasis on non-suicidal intent, association with tension reduction, reclaiming power and mastery over self and others, life and death instincts, the significance of bloodletting in a socio-cultural context, trans- generational conflicts, dysfunctional family dynamics frequently with parental separation and sexual abuse and early sexual induction.
文摘Background:A number of studies report high prevalence of mental health conditions among burn patients. However there is a need to understand differences in the temporal relationship between mental health conditions and intentional and unintentional burns to hasten psychological prevention and intervention. This study aims to compare the socio-demographic profile, burn characteristics and pre-and post-burn psychiatric morbidity of burn patients by intent-of-injury. Methods:De-identified linked hospital, death and mental health (MH) case registry data of burn patients hospitalised in Western Australia between 1 January 1980 and 30 June 2012 were analysed. Crude (observed) post-burn rates of mental health admissions were generated by burn intent-of-injury. Descriptive statistics were performed to compare the characteristics of the burn patients. Results:A total of 30,997 individuals were hospitalised for a first burn;360 (1.2%) had self-harm burns and 206 (0.7%) assault burns. Over the study period, admission rates for assault burns increased by 4.8%per year (95%confidence interval (CI) 3.1–6.5%) and self-harm burns increased 6.9%per year (95%CI 4.8–9.1%). Self-harm and assault burns occurred mainly among those aged 15 to 44 years (median age, interquartile range (IQR):self-harm 30 years, 22–40;assault 31 years, 23–38). Those with self-harm burns had a longer index hospital stay (median (IQR):self-harm 15 days (5–35) vs 4 days (1–11) assault vs 4 days (1–10) unintentional) and higher in-hospital mortality (7.2%self-harm vs 1.9%assault burns vs 0.8%unintentional). More than half (55.0%) of self-harm burns had a prior hospitalisation (5-year lookback) for a MH condition vs 10.7%of assault burns and 2.8%of unintentional burns. Crude post-burn rates of MH admissions per 100 person-years (PY) by intent-of-burn subgroups:self-harm 209 per 100 PY, assault burns 11 per 100 PY and unintentional burns 3 per 100 PY. Conclusions:Intentional burn patients experienced significantly higher pre-and post-burn mental health morbidity along with significant adverse outcome in comparison with unintentional burns. Early psychological assessment and intervention could help in improving the MH of these patients.
