Non-suicidal self-injury in older adults: a systematic review

Objectives Non-suicidal self-injury (NSSI) is a known precursor to suicide, which has the highest global rates among older adults. Yet, NSSI in later life remains poorly understood. This systematic review examined literature on NSSI in individuals aged 60+.Methods Following PRISMA guidelines, we searched six databases (PsycInfo, PsycARTICLES, PubMed, ScienceDirect, Scopus, and Web of Science) on May 25, 2025. Eligible studies were peer-reviewed, English-language, included adults ≥60, and reported on NSSI. Two reviewers independently extracted and appraised articles.Results Five cross-sectional studies published within the past decade met criteria. None used longitudinal designs or informant perspectives; most relied on retrospective data or single-item measures. Samples varied, and none focused exclusively on adults ≥60. Lifetime NSSI prevalence ranged 6.0–9.5%, past-year 1.4–4.1%, and past-month 2.9–6.3%. Some studies suggested declining prevalence with age, though findings were inconsistent across older subgroups. Common behaviours included scratching, punching, and head banging. Assessment methods varied; only one study used a validated NSSI-specific instrument. Overall study quality was moderate to high, with limitations in measurement validity and sample representativeness.Conclusion NSSI occurs in older adults but remains under-researched. Age-sensitive tools and targeted research are needed to improve identification, understanding, and intervention.