The authors have no competing interests.
All authors have contributed substantially to the manuscript. LM, IR and AJT participated in the design of the study, AJT drafted and revised the manuscript and IR, LM and EM made substantial contributions in revising it. AJT, IR and EM were involved in running the statistical analysis, and all authors were involved in interpretation of the analyses. All authors were involved in the interpretation of data. All have read and approved the final manuscript.
Studies have shown that adolescents with a history of both suicide attempts and non-suicidal self-harm report more mental health problems and other psychosocial problems than adolescents who report only one or none of these types of self-harm. The current study aimed to examine the use of child and adolescent psychiatric services by adolescents with both suicide attempts and non-suicidal self-harm, compared to other adolescents, and to assess the psychosocial variables that characterize adolescents with both suicide attempts and non-suicidal self-harm who report contact.
Data on lifetime self-harm, contact with child and adolescent psychiatric services, and various psychosocial risk factors were collected in a cross-sectional sample (response rate = 92.7%) of 11,440 adolescents aged 14–17 years who participated in a school survey in Oslo, Norway.
Adolescents who reported any self-harm were more likely than other adolescents to have used child and adolescent psychiatric services, with a particularly elevated likelihood among those with both suicide attempts and non-suicidal self-harm (OR = 9.3). This finding remained significant even when controlling for psychosocial variables. In adolescents with both suicide attempts and non–suicidal self-harm, symptoms of depression, eating problems, and the use of illicit drugs were associated with a higher likelihood of contact with child and adolescent psychiatric services, whereas a non-Western immigrant background was associated with a lower likelihood.
In this study, adolescents who reported self-harm were significantly more likely than other adolescents to have used child and adolescent psychiatric services, and adolescents who reported a history of both suicide attempts and non-suicidal self-harm were more likely to have used such services, even after controlling for other psychosocial risk factors. In this high-risk subsample, various psychosocial problems increased the probability of contact with child and adolescent psychiatric services, naturally reflecting the core tasks of the services, confirming that they represents an important area for interventions that aim to reduce self-harming behaviour. Such interventions should include systematic screening for early recognition of self-harming behaviours, and treatment programmes tailored to the needs of teenagers with a positive screen. Possible barriers to receive mental health services for adolescents with immigrant backgrounds should be further explored.
Nock MK: Self-injury. Annu Rev of Clin Psych. 2010, 6: 339-363. 10.1146/annurev.clinpsy.121208.131258. CrossRef
Muehlenkamp JJ, Claes L, Havertape L, Plener PL: International prevalence of adolescent non-suicidal self-injury and deliberate self-harm. Child Adolesc Psychiatry Ment Health. 2012, 6: 6-10. 10.1186/1753-2000-6-6. CrossRef
Nock MK, Green JG, Hwang I, McLaughlin KA, Sampson NA, Zaslavsky AM, Kessler RC: Prevalence, correlates, and treatment of lifetime suicidal behavior among adolescents: results from the national comorbidity survey replication adolescent supplement. JAMA Psychiatry. 2013, 70: 1-11. CrossRef
Portzky G, Audenaert K, van Heeringen K: Psychosocial and psychiatric factors associated with adolescent suicide: a case–control psychological autopsy study. J Adolescence. 2009, 32: 849-862. 10.1016/j.adolescence.2008.10.007. CrossRef
Madge N, Hewitt A, Hawton K, Wilde EJ, Corcoran P, Fekete S, van Heeringen K, De Leo D, Ystgaard M: Deliberate self-harm within an international community sample of young people: comparative findings from the Child & Adolescent Self-harm in Europe (CASE) Study. J Child Psychol Psychiatry. 2008, 49: 667-77. 10.1111/j.1469-7610.2008.01879.x. CrossRefPubMed
Skegg K: Self-harm. The Lancet. 2005, 366: 1471-1483. 10.1016/S0140-6736(05)67600-3. CrossRef
Ystgaard M, Reinholdt NP, Husby J, Mehlum L: Deliberate self harm in adolescents. Norwegian. Tidsskr Nor Laegeforen. 2003, 123: 2241-2245. PubMed
Groholt B, Ekeberg O, Wichstrom L, Haldorsen T: Youth suicide in Norway, 1990–1992: a comparison between children and adolescents completing suicide and age- and gender-matched controls. Suicide Life Threat Behav. 1997, 27: 250-263. PubMed
Olweus D: Bully/victim problems among school children: basic facts and effects of a school based intervention program. The Development andTreatment of Childhood Aggression. Edited by: Pepler D, Rubin K. 1991, Hillsdale, NJ: Erlbaum, 411-448.
Bruffaerts R, Demyttenaere K, Hwang I, Chiu WT, Sampson N, Kessler RC, Alonso J, Borges G, de Girolamo G, de Graaf R, Florescu S, Gureje O, Karam C, Kawakami N, Kostyuchenko S, Kovess-Masfety V, Lee S, Levinson D, Matschinger H, Posada-Villa J, Sagar R, Scott KM, Stein DJ, Tomov T, Viana MC, Nock MC: Treatment of suicidal people around the world. Br J Psychiatry. 2011, 199: 64-70. 10.1192/bjp.bp.110.084129. PubMedCentralCrossRefPubMed
Andersson HW: Pasienter og behandlingstilbud i psykisk helsevern for barn og unge. 2009, Trondheim: SINTEF
Kohn R, Saxena S, Levav I, Saraceno B: The treatment gap in mental health care. World Health Organisation. 2005, 82 (11): 858-866.
- Contact with child and adolescent psychiatric services among self-harming and suicidal adolescents in the general population: a cross sectional study
Anita J Tørmoen
- BioMed Central
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