Risk factors for non-suicidal self-injury (NSSI) in adolescents: A meta-analysis

BackgroundNon-suicidal self-injury (NSSI) in adolescents is a significant mental health problem around the world. Here, we performed a meta-analysis to systematically delineate the risk factors for NSSI.MethodWe searched Medline, Embase, Web of Science and Cochrane for relevant articles and abstracts published prior to 12 November 2021. Pooled odds ratios (ORs) and 95% confident intervals (CIs) were used to assess various risk factors, and publication bias was assessed by Egger's test, the trim and fill method and meta-regression. This study is registered with PROSPERO, CRD42021265885.ResultsA total of 25 articles were eventually included in the analysis. Eighty risk factors were identified and classified into 7 categories: mental disorders (ORs, 1·89; 95% CI, 1·60–2·24), bullying (ORs, 1·98; 95% CI, 1·32–2·95), low health literacy (ORs, 2·20; 95% CI, 1·63–2·96), problem behaviours (ORs, 2·36; 95% CI, 2·00–2·77), adverse childhood experiences (ORs, 2·49; 95% CI, 1·85–3.34), physical symptoms (ORs, 2·85; 95% CI, 1·36–5·97) and the female gender (ORs, 2·89; 95% CI, 2·43–3·43). The range of heterogeneity (I2) was from 20·3% to 99·2%.ConclusionThis meta-analysis found that mental disorders, low health literacy, adverse childhood experiences, bullying, problem behaviours, the female gender and physical symptoms appear to be risk factors for NSSI.FundingNSFC grant (81,822,017), National Key R&D Program of China (2020YFA0113600), Natural Science Foundation of Zhejiang Province, China (No. LY19H090015), Shenzhen-Hong Kong Institute of Brain Science - Shenzhen Fundamental Research Institutions (NYKFKT20190020), Shanghai Municipal Education Commission - Gaofeng Clinical Medicine Grant Support (20,181,715), Social Science Foundation of China (BIAl80167).