Relationship Between Predictors of Incident Deliberate Self-Harm and Suicide Attempts Among Adolescents.
OBJECTIVE
Data on the incidence of deliberate self-harm (DSH) and suicide attempts (SAs) are lacking in non-Western adolescents, and no studies have investigated differences in incident DSH and SA worldwide. This study aimed to investigate the incidence rates and relationships between predictors in DSH and SA.


METHODS
The Taiwanese Adolescent Self-Harm Project was a longitudinal study of DSH among adolescents. We recruited 5,879 students from 14 senior high schools in northern Taiwan. Online questionnaires on sociodemographic data, suicidality, depressive symptoms, self-esteem, social support, family discord, impulsivity, and alcohol and tobacco use were assessed at baseline (T1) and at 1 year of follow-up (T2). Logistic regression analyses were performed to evaluate the predictors of incident DSH and SA.


RESULTS
The mean age was 16.02 years, and 56.73% of the cohort was female. At T1, the lifetime prevalence rates of DSH and SA were 25.04% and 3.50%, respectively. At T2, 4,331 (73.67%) students had completed follow-up assessments. The 1-year incidence rates of DSH and SA were 4.04% and 1.53%, respectively. The predictors of incident DSH included perceived family discord and more depressive symptoms at T1. The predictors of incident SA were lifetime suicide ideation, more depressive symptoms, and tobacco use at T1.


CONCLUSIONS
The incidence rates of DSH and SA were similar to those reported in Western countries. The predictors of incident DSH and SA were similar but not identical. Our results highlight the risk factors which should be considered in terms of early identification and intervention among adolescents to prevent suicidality.
Department of Medicine, Mackay Medical College, New Taipei City, Taiwan; Department of Psychiatry, Mackay Memorial Hospital, Taipei, Taiwan; Suicide Prevention Center, Mackay Memorial Hospital, Taipei, Taiwan; Mackay Junior College of Medicine, Nursing, and Management, Taipei, Taiwan.
Yu-Hsin
YH
Huang
Department of Psychiatry, Mackay Memorial Hospital, Taipei, Taiwan; Suicide Prevention Center, Mackay Memorial Hospital, Taipei, Taiwan; Mackay Junior College of Medicine, Nursing, and Management, Taipei, Taiwan.
Hui-Ching
HC
Liu
Mackay Junior College of Medicine, Nursing, and Management, Taipei, Taiwan; Department of Medical Research, Mackay Memorial Hospital, New Taipei City, Taiwan.
Fang-Ju
FJ
Sun
Department of Psychiatry, En Chu Kong Hospital, New Taipei City, Taiwan; Department of Psychiatry, College of Medicine, National Taiwan University, Taipei, Taiwan; Department of Psychiatry, National Taiwan University Hospital, Taipei City, Taiwan.
Fang-Ju
FJ
Tsai
Department of Psychiatry, Taiwan Adventist Hospital, Taipei, Taiwan.
Kuo-Yang
KY
Huang
Department of Special Education, University of Taipei, Taipei, Taiwan.
Ting-Chun
TC
Chen
Department of Electrical Engineering, National Taipei University of Technology, Taipei, Taiwan.
Yo-Ping
YP
Huang
Department of Medicine, Mackay Medical College, New Taipei City, Taiwan; Department of Psychiatry, Mackay Memorial Hospital, Taipei, Taiwan; Suicide Prevention Center, Mackay Memorial Hospital, Taipei, Taiwan; Mackay Junior College of Medicine, Nursing, and Management, Taipei, Taiwan; Department of Medical Research, Mackay Memorial Hospital, New Taipei City, Taiwan. Electronic address: maryliuyip@gmail.com.
Shen-Ing
SI
Liu
D000293:Adolescent; D003430:Cross-Sectional Studies; D003863:Depression / Q000523:psychology; D054541:Family Conflict / Q000523:psychology; D005260:Female; D006801:Humans; D015994:Incidence; D016015:Logistic Models; D008137:Longitudinal Studies; D008297:Male; D011569:Psychiatric Status Rating Scales; D012307:Risk Factors; D016728:Self-Injurious Behavior / Q000453:epidemiology* / Q000523:psychology*; D017678:Sex Distribution; D012907:Smoking / Q000453:epidemiology; D059020:Suicidal Ideation; D013406:Suicide, Attempted / Q000523:psychology* / Q000706:statistics & numerical data*; D011795:Surveys and Questionnaires; D013624:Taiwan / Q000453:epidemiology
Adolescent; Attempted; Deliberate self-harm; Incidence; Longitudinal studies; Risk factors; Suicide