Risk factors for non-suicidal self-injury (NSSI) in adolescents: A meta-analysis

Yu-Jing Wang; Xi Li; Chee H Ng; Dong-Wu Xu; Shaohua Hu; Ti-Fei Yuan

doi:10.1016/j.eclinm.2022.101350

Risk factors for non-suicidal self-injury (NSSI) in adolescents: A meta-analysis

EClinicalMedicine. 2022 Mar 21:46:101350. doi: 10.1016/j.eclinm.2022.101350. eCollection 2022 Apr.

Authors

Yu-Jing Wang¹, Xi Li¹, Chee H Ng², Dong-Wu Xu¹, Shaohua Hu^{3

4

5

6

7}, Ti-Fei Yuan^{8

9

10}

Affiliations

¹ Zhejiang Provincial Clinical Research Center for Mental Disorders, School of Mental Health and The Affiliated Wenzhou Kangning Hospital, Wenzhou Medical University, Wenzhou, Zhejiang 325000, China.
² Department of Psychiatry, The Melbourne Clinic and St Vincent's Hospital, University of Melbourne, Richmond, VIC, SA.
³ Department of Psychiatry, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China.
⁴ The Key Laboratory of Mental Disorders Management in Zhejiang Province, Hangzhou, China.
⁵ Brain Research Institute of Zhejiang University, Hangzhou, China.
⁶ Zhejiang Engineering Center for Mathematical Mental Health, Hangzhou, China.
⁷ MOE Frontier Science Center for Brain Science and Brain-Machine Integration, Zhejiang University, Hangzhou, China.
⁸ Shanghai Key Laboratory of Psychotic disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
⁹ Co-innovation Center of Neuroregeneration, Nantong University, Nantong, China.
¹⁰ Translational Research Institute of Brain and Brain-Like Intelligence, Shanghai Fourth People's Hospital Affiliated to Tongji University School of Medicine, Shanghai, China.

Abstract

Background: Non-suicidal self-injury (NSSI) in adolescents is a significant mental health problem around the world. Here, we performed a meta-analysis to systematically delineate the risk factors for NSSI.

Method: We searched Medline, Embase, Web of Science and Cochrane for relevant articles and abstracts published prior to 12 November 2021. Pooled odds ratios (ORs) and 95% confident intervals (CIs) were used to assess various risk factors, and publication bias was assessed by Egger's test, the trim and fill method and meta-regression. This study is registered with PROSPERO, CRD42021265885.

Results: A total of 25 articles were eventually included in the analysis. Eighty risk factors were identified and classified into 7 categories: mental disorders (ORs, 1·89; 95% CI, 1·60-2·24), bullying (ORs, 1·98; 95% CI, 1·32-2·95), low health literacy (ORs, 2·20; 95% CI, 1·63-2·96), problem behaviours (ORs, 2·36; 95% CI, 2·00-2·77), adverse childhood experiences (ORs, 2·49; 95% CI, 1·85-3.34), physical symptoms (ORs, 2·85; 95% CI, 1·36-5·97) and the female gender (ORs, 2·89; 95% CI, 2·43-3·43). The range of heterogeneity (I²) was from 20·3% to 99·2%.

Conclusion: This meta-analysis found that mental disorders, low health literacy, adverse childhood experiences, bullying, problem behaviours, the female gender and physical symptoms appear to be risk factors for NSSI.

Keywords: Adolescents; Meta-analysis; Non-suicidal self-injury (NSSI); Risk factors.