Early Risk Factors for Self-Injurious Thoughts and Behaviours: A UK Population-Based Study of 219,581 People

Alejandro Porras-Segovia; Ana Pascual-Sanchez; Geva Greenfield; Hanna-Marie Creese; Sonia Saxena; Dougal Hargreaves; Dasha Nicholls

doi:10.3390/bs14010016

Early Risk Factors for Self-Injurious Thoughts and Behaviours: A UK Population-Based Study of 219,581 People

Behav Sci (Basel). 2023 Dec 24;14(1):16. doi: 10.3390/bs14010016.

Authors

Alejandro Porras-Segovia^{1

2

3}, Ana Pascual-Sanchez^{1

4}, Geva Greenfield⁵, Hanna-Marie Creese⁵, Sonia Saxena⁵, Dougal Hargreaves⁶, Dasha Nicholls¹

Affiliations

¹ Division of Psychiatry, Department of Brain Sciences, Imperial College London, London W12 7T, UK.
² Health Research Institute Fundación Jiménez Díaz, 28040 Madrid, Spain.
³ Department of Psychiatry, University Hospital Rey Juan Carlos, 28933 Madrid, Spain.
⁴ CAMHS Enhanced Treatment Service, South London and Maudsley NHS Foundation Trust, London SE5 8AZ, UK.
⁵ Department of Primary Care and Public Health, Imperial College London, London SW7 2AZ, UK.
⁶ Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London W2 1PG, UK.

Abstract

Mental disorders are a major problem among young people. To identify early risk factors of self-injurious thoughts and behaviours (SITB) among young adults with mental health problems, this case-control study drew data from the Clinical Practice Research Datalink (CPRD), a primary care database covering 8% of the UK population. We explored the role of early factors (presenting at 8-14 years old) for suicidal ideation, suicide attempts, and non-suicidal self-injury (NSSI) in young adulthood (age 18-25 years) by performing logistic regressions. Our sample consisted of 219,581 participants, of which 6.51% had at least one SITB in young adulthood. Early risk factors for SITB included early NSSI, suicidal ideation, sexual abuse, behavioural problems, and mood and psychotic symptoms. Frequency of GP visits had a protective effect. Lack of access to mortality data, ethnicity, and socioeconomic status was a limitation of the current study. In conclusion, early symptoms in late childhood/early adolescence can be the start of long-standing problems going into adult life. The training of primary care providers in suicide risk assessment and proper co-ordination with child and adolescent mental health services are crucial for suicide prevention.

Keywords: child and adolescent mental health; non-suicidal self-injury; suicide; suicide attempt; suicide ideation.

Grants and funding

This report is independent research supported by the National Institute for Health Research Applied Research Collaboration Northwest London. Authors’ sources of funding include the Carlos III Health Research Institute (ISCIII JR22/00011), the National Institute for Health Research and the School for Public Health Research (PD-SPH-2015). The views expressed in this publication are those of the authors.