青少年自伤患病率及其相关性的横断面研究

Priscila Naves Domingues, Tatiana Fonseca Da Silva
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摘要

引言:非自杀性自伤(NSSI)是指在没有自杀意图的情况下故意和自愿造成的身体伤害。然而,在那些以前参与过NSSI的人中,自杀的风险要高得多。青少年有发展这种行为的风险,因为大脑发育过程会导致冲动和情绪反应水平升高。方法:一项横断面调查,于2018年8月从巴西两所公立学校的140名青少年样本中收集数据。计算了自伤的发生率,并分析了相关因素,如性别、社会经济地位、发病年龄、复发、死亡意向和医疗援助。结果:自伤发生率为25%(n=35)。女孩自伤的可能性是男孩的7倍(OR 7.42;95%CI 2.80-19.66;p<0.001)。然而,男孩更有可能死亡、复发、没有疼痛和没有医疗援助。大多数病例的发病年龄为13至15岁。超过三分之一的参与者报告了多次自伤发作(5次或5次以上),他们有死亡意图的可能性是其他参与者的13倍(or 13.2;95%CI 1.44-120.69;p=0.010)。只有一人报告每天使用药物(选择性血清素再摄取抑制剂),28.6%的人报告接受了专业医疗援助。结论:自伤是青少年的一种普遍行为,可能导致心理和身体损伤。进一步研究以更好地了解自伤的临床和流行病学特征至关重要,这样才能制定更有效的预防和治疗干预措施,以满足世界各地年轻人的需求。
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Prevalence and Correlates of Self-Injury among Adolescents: A Cross-Sectional Study
Introduction: Non-suicidal self-injury (NSSI) is defined as a deliberate and voluntary self-inflicted physical damage without suicidal intent. However, the risk of suicide is significantly higher among those who have previously engaged in NSSI. Adolescents are at risk for developing this type of behavior, as elevated levels of impulsivity and emotional reactivity are present due to brain developmental processes. Methods: A cross-sectional survey that collected data from a sample of 140 adolescents from two Brazilian public schools in august of 2018. The prevalence of self-injury was calculated, and related factors were analyzed, such as sex, socioeconomic status, age of onset, recurrence, intention to die and healthcare assistance. Results: The prevalence of self-injury was 25% (n = 35) in the sample. Girls were seven times more likely to practice self-injury than boys (OR 7.42; 95% CI 2.80-19.66; p<0.001). However, boys were more likely to have intention to die, recurrence, absence of pain, and no healthcare assistance. The age of onset was 13 to 15 years for most cases. More than one third of participants reported multiple episodes of self-injury (five episodes or more) and they were 13 times more likely to have intention to die (OR 13.2; 95% CI 1.44-120.69; p=0.010). Only one person reported using medication on a daily basis (selective serotonin reuptake inhibitor) and 28.6% reported undergoing professional healthcare assistance. Conclusion: Self-injury is a prevalent behavior in adolescents, that potentially results in psychological and physical impairments. Further research to achieve a better understanding of clinical and epidemiological features of self-injury is essential so that more effective preventive and therapeutic interventions can be developed to target the needs of young people worldwide.
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