Clinical and psychosocial correlates of non-suicidal self-injury within a sample of children and adolescents with bipolar disorder.
BACKGROUND
The purpose of this study is to examine the prevalence and correlates of non-suicidal self-injury (NSSI) among children and adolescents diagnosed with bipolar disorder (BP).


METHODS
Four hundred-thirty two youth with a diagnosis of BP and their parents, including 193 children and 239 adolescents, completed a diagnostic interview and instruments to assess youth clinical and illness history, youth comorbidity, parental mood disorder, and psychosocial functioning.


RESULTS
Approximately 22% of children and 22% of adolescents reported NSSI during the course of their most recent mood episode. In a multivariate model controlling for global impairment, among children, a BPI or BPII diagnosis (versus BPNOS), psychosis, separation anxiety disorder, and greater severity of depressive symptoms were found to be associated with NSSI. Among adolescents, a mixed episode, a suicide attempt, greater severity of depressive symptoms, and poor psychosocial functioning were found to be associated with NSSI. Neither the presence of a youth comorbid disruptive behavior disorder nor a parental mood disorder was associated with NSSI.


CONCLUSIONS
The primary limitations of this study include the use of a cross-sectional study design, lack of a control group, and limited generalizability of study results to non-clinical and ethnically diverse samples.


CONCLUSIONS
NSSI is not uncommon among youth with BP, particularly those who present with BPI or BPII, psychosis, a mixed episode, suicidal behavior, severe depressive symptoms, separation anxiety, and/or poor psychosocial functioning. However, the relative importance of these factors in relation to NSSI may vary with age. Treatments for BP that are developmentally sensitive, examine the function of NSSI for each youth, and teach adaptive skills to address emotional and social needs, may prove to be most successful.
Esposito-Smythers
Christianne
C
George Mason University, Department of Psychology, 4400 University Drive, MSN 3F5, Fairfax, VA 22030, United States. cesposi1@gmu.edu
Goldstein
Tina
T
Birmaher
Boris
B
Goldstein
Benjamin
B
Hunt
Jeffrey
J
Ryan
Neal
N
Axelson
David
D
Strober
Michael
M
Gill
Mary Kay
MK
Hanley
Andrea
A
Keller
Martin
M
D000293:Adolescent; D001714:Bipolar Disorder / Q000175:diagnosis / Q000453:epidemiology* / Q000523:psychology*; D002648:Child; D015897:Comorbidity; D003430:Cross-Sectional Studies; D039721:Diagnostic and Statistical Manual of Mental Disorders; D005260:Female; D006801:Humans; D007406:Interview, Psychological; D008137:Longitudinal Studies; D008297:Male; D016728:Self-Injurious Behavior / Q000175:diagnosis / Q000453:epidemiology* / Q000523:psychology*; D012917:Social Adjustment; D013406:Suicide, Attempted / Q000523:psychology / Q000706:statistics & numerical data; D014481:United States