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Abstract
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Purpose
Non-suicidal self-harm is very common among adolescents, and China's attention to the problem of adolescent self-harm is still insufficient. This study explored adolescents’ self-harm behavior and its relationship with family, school work, mood and suicide factors through a questionnaire survey of adolescents and their parents.
Method
All subjects were from the Department of Psychiatry, the First Affiliated Hospital of Zhejiang University School of Medicine. According to the diagnostic criteria of the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), adolescents diagnosed with major depressive disorder or bipolar disorder and their parents were included. A total of 70 teenagers and 59 parents participated in the study. Researchers collected the demographic characteristics and related information of adolescents' self-harm, including data reported by patients and parents. Spearman rank correlation analysis was used to calculate the correlation between self-injury and other factors.
Result
The average age of the adolescents tested was (16.1±2.4) years old. Among adolescents with non-suicidal self-harm behavior, women account for 35 cases (79.5%). Among the tested adolescents, 38 (54.3%) reported self-harm behavior in the month before the survey, and 26 (37.1%) reported self-harm behavior more than 5 times in the past year. The above two parents reported data There were 11 people (18.6%) and 4 people (6.8%). The proportion of adolescents with feelings of despair (68.6%), hope of death (62.9%), suicidal thoughts (70.0%), and the idea of unexpectedly ending their lives (62.9%) is higher, while the proportion of the above-mentioned emotional disorders reported by parents is relatively low, respectively They were 37.3%, 23.7%, 6.8% and 11.9%. Among the factors related to non-suicidal self-injury, bad family relationships, learning pressure, and emotional problems such as "no one talks about grief", "psychological pain cannot be understood", etc., are common in the reports of the tested adolescents and their parents exist. The positively correlated factors reported by adolescents with "self-harming behavior within one month" include "despair", "suicidal thoughts", "hope to end life unexpectedly" and "hurrying to deal with affairs due to expected death" (ρ 0.429, respectively) 0.463, 0.482 and 0.483, all P<0.05). It is worth noting that "hope to die" and "hope to end life unexpectedly" (ρ are 0.407 and 0.407, all P<0.05) are also strong positive correlation factors of "self-injury more than 5 times in the past year". In the parent report, "despair" was the only factor that was positively correlated with "self-harm behavior within one month" (ρ=0.261, P<0.05).
Conclusion
Chinese adolescents with mood disorders are at higher risk of non-suicidal self-harm behavior, which is positively correlated with suicidal conceptions. Parents of adolescents with non-suicidal self-harm may have underestimated this situation and need to pay more attention to this situation.
目的
非自杀性自伤在青少年群体中很常见,中国对青少年自伤问题的关注仍不充分。本研究通过对青少年及其父母的问卷调查,探讨了青少年的自伤行为,及其与家庭、学业、情绪和自杀因素的关系。
方法
所有受试者均来自浙江大学医学院第一附属医院精神科。根据《精神障碍诊断与统计手册》第五版(DSM-5)的诊断标准,纳入诊断为重度抑郁障碍或双相情感障碍的青少年及其父母。共有70名青少年和59名家长参加了这项研究。研究人员收集了青少年自伤的人口学特征和相关信息,包括患者和家长报告的数据。采用斯皮尔曼秩相关分析计算自伤与其他因素的相关性。
结果
受试的青少年平均年龄为(16.1±2.4)岁。在有非自杀性自伤行为的青少年中,女性占35例(79.5%)。受试青少年中,38人(54.3%)报告了调查前一个月内的自伤行为,26人(37.1%)报告了在过去一年内5次以上的自伤行为,以上两项父母报告的数据分别为11人(18.6%)和4人(6.8%)。有绝望感(68.6%)、希望死亡(62.9%)、自杀念头(70.0%)以及希望意外结束生命(62.9%)想法的青少年比例较高,而父母报告的上述情绪障碍比例相对较低,分别为37.3%、23.7%、6.8%和11.9%。在与非自杀性自伤相关的因素中,不良的家庭关系、学习压力和情感问题如"悲伤时无人倾诉"、"心理痛苦无法理解"等,在受试青少年和家长的报告中都普遍存在。青少年报告的与"一个月内自伤行为"呈正相关的因素包括"绝望感"、"自杀念头"、"希望意外结束生命"和"由于预期中的死亡匆忙处理事务" (ρ分别为0.429、0.463、0.482和0.483,所有P<0.05)。值得注意的是,"希望死亡"和"希望意外结束生命"(ρ分别为0.407和0.407,所有P<0.05)也是"过去一年中自伤5次以上"的强正相关因素。在家长报告中,"绝望感"是唯一和"一个月内自伤行为"呈正相关的因素(ρ=0.261,P<0.05).
结论
有心境障碍的中国青少年实行非自杀性自伤行为的风险较高,且与自杀观念呈正相关。有非自杀性自伤的青少年的父母可能低估了这种情况,需要更重视这方面的情况。
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