Cookies on this website
We use cookies to ensure that we give you the best experience on our website. If you click 'Continue' we'll assume that you are happy to receive all cookies and you won't see this message again. Click 'Find out more' for information on how to change your cookie settings.

BACKGROUND: Psychiatric disorders occur in approximately 90% of individuals dying by suicide. The prevalence of psychiatric disorders in people who engage in non-fatal self-harm has received less attention. METHOD: Systematic review using electronic databases (Embase, PsychINFO and Medline) for English language publications of studies in which psychiatric disorders have been assessed using research or clinical diagnostic schedules in self-harm patients of all ages presenting to general hospitals, followed by meta-analyses using random effects methods. RESULTS: A total of 50 studies from 24 countries were identified. Psychiatric (Axis I) disorders were identified in 83.9% (95% CI 74.7-91.3%) of adults and 81.2% (95% CI 60.9-95.5%) of adolescents and young persons. The most frequent disorders were depression, anxiety and alcohol misuse, and additionally attention deficit hyperactivity disorder (ADHD) and conduct disorder in younger patients. Personality (Axis II) disorders were found in 27.5% (95% CI 17.6-38.7%) of adult patients. Psychiatric disorders were somewhat more common in patients in Western (89.6%, 95% CI 83.0-94.7%) than non-Western countries (70.6%, 95% CI 50.1-87.6%). LIMITATIONS: Heterogeneity between study results was generally high. There were differences between studies in identification of study participants and diagnostic procedures. CONCLUSIONS: Most self-harm patients have psychiatric disorders, as found in people dying by suicide. Depression and anxiety disorders are particularly common, together with ADHD and conduct disorder in adolescents. Psychosocial assessment and aftercare of self-harm patients should include careful screening for such disorders and appropriate therapeutic interventions. Longitudinal studies of the progress of these disorders are required.

Original publication

DOI

10.1016/j.jad.2013.08.020

Type

Journal

J Affect Disord

Publication Date

12/2013

Volume

151

Pages

821 - 830

Keywords

Attempted suicide, Personality disorders, Psychiatric disorders, Self-harm, Systematic review, Adolescent, Adult, Age Factors, Anxiety Disorders, Female, Hospitalization, Humans, Male, Mental Disorders, Middle Aged, Mood Disorders, Self-Injurious Behavior, Substance-Related Disorders, Suicide, Attempted, Young Adult