Prevalence and Associated Factors of Self-harm in Children and Adolescent Patients with Depressive Disorder at Samutprakarn Hospital
Article Sidebar
Main Article Content
Abstract
Objective: To determine the prevalence and associated factors of self-harm in children and adolescent patients with depressive disorder at Samutprakarn hospital.
Method: This retrospective analytic study was done on 257 records of the patients with first diagnosed depressive disorder aged 8 - 18 years old who attended Samutprakarn hospital from January 2021 to December 2023. Demographic, illness history, self-harm history, family and psychosocial data were collected. The Children’s Depression Inventory (CDI) and 9 Questions Depression rating scale (9Q) were used to categorize the severity of depression in patients aged less than 15 years old and patients aged 15 - 18 years old respectively. Data were analyzed using descriptive statistics, chi-square, t-test, Mann-Whitney U test and binary logistic regression.
Result: 257 records of children and adolescent patients with depressive disorder were included, with a median age 15 years old (P25-P75 = 13.74 - 17 year), the prevalence of self-harm was 59.9%. The most common methods included using sharp objects 69.5%, taking overdosed drugs 37.2%, and hitting oneself 25.3%. The most common self-injurious intentions were venting emotions 85.1%, intending to commit suicide/death 44.2% and sarcastic/seeking attention 8.4%. The two factors that were statistically significant associated with self-harm were death wish/suicidal ideation (AOR = 3.091, 95% CI = 1.749 - 5.462, p <0.001) and severity of depressive symptoms (AOR = 3.569, 95% CI 1.908 - 6.675, p<0.001).
Conclusion: The prevalence of self-harm in children and adolescent patients with depression at Samutprakarn hospital was 59.9%. Death wish/suicidal ideation and the severity of depressive symptoms were significantly related to the risk of self-injurious behavior in this group of patients.
Article Details
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
Articles submitted for consideration must not have been previously published or accepted for publication in any other journal, and must not be under review by any other journal.
References
Department of Psychiatry, Faculty of Medicine Siriraj hospital. Psychiatry Siriraj DSM-5. 1st ed. Sitdhiraksa N, editor. Bangkok: Prayoonsarnthai; 2015.
Shorey S, Ng ED, Wong CHJ. Global prevalence of depression and elevated depressive symptoms among adolescents: A systematic review and meta-analysis. Br J Clin Psychol 2022; 61(2) :287-305.
Hawton, K., O'Connor, R.C. and Saunders. Suicidal behavior and self-harm. In: Rutter M, Bishop DVM, Pine DS, Stevenson J, editors. Rutter's Child and Adolescent Psychiatry. 6th ed. Wiley-Blackwell; 2015. p. 893-910.
Hawton K, Saunders KEA, O’Connor RC. Self-harm and suicide in adolescents. Lancet 2012; 379(9834): 2373–82.
Lucena NL, Rossi TA, Azevedo LMG, Pereira M. Self-injury prevalence in adolescents: A global systematic review and meta-analysis. Child Youth Serv Rev 2022; 142: 10663.
Farkas BF, Takacs ZK, Kollárovics N. The prevalence of self-injury in adolescence: a systematic review and meta-analysis. Eur Child Adolesc Psychiatry 2024; 33(10): 3439-58.
Breaux R, Dvorsky MR, Marsh NP, Green CD, Cash AR, Shroff DM, et al. Prospective impact of COVID-19 on mental health functioning in adolescents with and without ADHD: protective role of emotion regulation abilities. J Child Psychol Psychiatry 2021; 62(9): 1132-39.
Chesin MS, Galfavy H, Sonmez CC, Wong A, Oquendo MA, Mann JJ, et al. Nonsuicidal self-injury is predictive of suicide attempts among individuals with mood disorders. Suicide Life Threat Behav 2017; 47(5): 567-579.
Xiao Q, Song X, Huang L, Hou D, Huang X. Global prevalence and characteristics of non-suicidal self-injury between 2010 and 2021 among a non-clinical sample of adolescents: A meta-analysis. Front Psychiatry 2022; 13: 912441.
He H, Hong L, Jin W, Xu Y, Kang W, Liu J, et al. Heterogeneity of non-suicidal self-injury behavior in adolescents with depression: latent class analysis. BMC Psychiatry 2023; 23(1).
Panyawong W. Prevalence of depression and suicidal risks in Thai adolescents: a survey in schools from 13 Public Health Region Received. J Ment Heal Thail. 2020; 28(2): 136–49.
Lawrence D, Johnson S, Hafekost J, Haan KB de, Sawyer M, Ainley J, et al. The mental health of children and adolescents: Report on the second Australian child and adolescent survey of mental health and wellbeing. Canberra (AU); Department of Health. 2015. 222p.
Kang L, Li R, Liu H, Ma S, Sun S, Zhang N, et al. Nonsuicidal self-injury in undergraduate students with major depressive disorder: The role of psychosocial factors. J Affect Disord 2021; 290: 102–8.
Wu B, Zhang H, Chen J, Chen J, Liu Z, Cheng Y, et al. Potential mechanisms of non-suicidal self-injury (NSSI) in major depressive disorder: A systematic review. Gen Psychiatr 2023; 36(4): e100946.
Serra M, Presicci A, Croce F, Marzulli L, Quaranta L, Caputo E, et al. Assessing clinical features of adolescents suffering from depression who engage in non-suicidal self-injury. Children 2022; 9(2): 201.
Qian H, Shu C, Feng L, Xiang J, Guo Y, Wang G. Childhood maltreatment, stressful life events, cognitive emotion regulation strategies, and non-suicidal self-injury in adolescents and young adults with first-episode depressive disorder: direct and indirect pathways. Front Psychiatry 2022; 13: 838693.
Zubrick SR, Hafekost J, Johnson SE, Sawyer MG, Patton G, Lawrence D. The continuity and duration of depression and its relationship to non-suicidal self-harm and suicidal ideation and behavior in adolescents 12–17. J Affect Disord 2017; 220: 49-56.
Shao C, Wang X, Ma Q, Zhao Y, Yun X. Analysis of risk factors of non-suicidal self-harm behavior in adolescents with depression. Ann Palliat Med 2021; 10(9): 9607–13.
Liu RT, Walsh RFL, Sheehan AE, Cheek SM, Sanzari CM. Prevalence and correlates of suicide and nonsuicidal self-injury in children: a systematic review and meta-analysis. JAMA Psychiatry 2022; 79(7): 718-26.
Trangkasombat U, Likanapichitkul D. The Children’s Depression Inventory as a Screen for Depression in Thai Children. J Med Assoc Thail 1996; 41: 222–34.
Department of Mental Health. Children’s Depression Inventory (CDI) Thai version [Internet]. Department of Mental Health. [cited 2017 Sep 24]. Available from: https://www.dmh.go.th/test/download/view.asp?id=19.
Bang YR, Park JH, Kim SH. Cut-off scores of the children’s depression inventory for screening and rating severity in Korean adolescents. Psychiatry Investig 2015; 12(1): 23-8.
Kongsuk T, Arunpongpaisal S, Janthong S, Prukkanone B, Sukhawaha S, Leejongpermpoon J. Criterion-related validity of the 9 questions depression rating scale revised for thai central dialect. J Psychiatr Assoc Thail 2018; 63(4): 321-334.
Shen Y, Hu Y, Zhou Y, Fan X. Non-suicidal self-injury function: prevalence in adolescents with depression and its associations with non-suicidal self-injury severity, duration and suicide. Front Psychiatry 2023; 14: 1188327.
Grandclerc S, De Labrouhe D, Spodenkiewicz M, Lachal J, Moro MR. Relations between nonsuicidal self-injury and suicidal behavior in adolescence: A systematic review. PLoS One 2016; 11(4): e0153760.
Pompili M, Goracci A, Giordano G, Erbuto D, Girardi P, Klonsky ED, et al. Relationship of non-suicidal self-injury and suicide attempt: A psychopathological perspective. J Psychopathol. 2015; 21: 348-53.
Tuisku V, Pelkonen M, Kiviruusu O, Karlsson L, Ruuttu T, Marttunen M. Factors associated with deliberate self-harm behaviour among depressed adolescent outpatients. J Adolesc 2009; 32(5): 1125-36.
Kang B, Hwang J, Woo S Il, Hahn SW, Kim M, Kim Y, et al. The mediating role of depression severity on the relationship between suicidal ideation and self-injury in adolescents with major depressive disorder. J Korean Acad Child Adolesc Psychiatry 2022; 33(4): 99-105.
Luby JL, Whalen D, Tillman R, Barch DM. Clinical and psychosocial characteristics of young children with suicidal ideation, behaviors, and nonsuicidal self-injurious behaviors. J Am Acad Child Adolesc Psychiatry 2019; 58(1): 117-27.
Benarous X, Consoli A, Cohen D, Renaud J, Lahaye H, Guilé JM. Suicidal behaviors and irritability in children and adolescents: a systematic review of the nature and mechanisms of the association. Eur Child Adolesc Psychiatry 2019; 28(5): 667-83.
