[When is self-injury nonsuicidal? Reviewing the relationship between suicial and nonsuicidal self-injury].Psychiatr Hung. 2020; 35(4):476-483.PH
The fifth edition of the Diagnostic and Statistical Manual of Mental Disorders has included nonsuicidal self-injury (NSSI) as a proposed independent diagnostic category, emphasizing the nonsuicidal nature of the phenomenon. Nevertheless, this terminology and concept have provoked a still ongoing scientific debate among researchers and clinicians.
By extending a systematic search with a broader focus on the prevalence and psychopathological correlates of NSSI, the aim of the present study is to explore the relationships between NSSI and suicidal behavior.
A systematic literature search was conducted in five databases (PubMed, OVID Medline, OVID PsycINFO, Scopus, Web of Science) with the search terms "NSSI" and "prevalence" and "mental disorder" or "psychiatric disorder". The results were completed by manual searches. Inclusion criteria were for each publication to be an empirical study in English language that does not focus on a specific population.
A total of 25 papers examined the relationship between NSSI and suicidality explicitly. Among these papers, fifteen focused on children/adolescents, five on young adults, four on adults, and one on participants from heteroge - neous age groups. According to the results reviewed, altogether 50-70% of those who engaged in NSSI also reported suicidal thoughts or attempts. Those who did not report suicidal ideation differed from those who reported both NSSI and suicidal ideation in certain intra- and interpersonal traits (e.g., less depressive and borderline personality disor der symptoms, fewer negative life events, more social support) and in some specific characteristics (e.g., higher frequency and higher number methods) of NSSI.
Based on the publications reviewed, significant suicidal risk is associated with NSSI in both adolescence and adulthood. This risk may be even higher in the presence of certain comorbid disorders and other psychosocial factors as well as in the presence of certain NSSI patterns such as repetitiveness or multiple NSSI methods.