Prevalence and Correlates of Self-Injury among Adolescents: A Cross-Sectional Study

Introduction: Non-suicidal self-injury (NSSI) is defined as a deliberate and voluntary self-inflicted physical damage without suicidal intent. However, the risk of suicide is significantly higher among those who have previously engaged in NSSI. Adolescents are at risk for developing this type of behavior, as elevated levels of impulsivity and emotional reactivity are present due to brain developmental processes. 
Methods: A cross-sectional survey that collected data from a sample of 140 adolescents from two Brazilian public schools in august of 2018. The prevalence of self-injury was calculated, and related factors were analyzed, such as sex, socioeconomic status, age of onset, recurrence, intention to die and healthcare assistance. 
Results: The prevalence of self-injury was 25% (n = 35) in the sample. Girls were seven times more likely to practice self-injury than boys (OR 7.42; 95% CI 2.80-19.66; p<0.001). However, boys were more likely to have intention to die, recurrence, absence of pain, and no healthcare assistance. The age of onset was 13 to 15 years for most cases. More than one third of participants reported multiple episodes of self-injury (five episodes or more) and they were 13 times more likely to have intention to die (OR 13.2; 95% CI 1.44-120.69; p=0.010). Only one person reported using medication on a daily basis (selective serotonin reuptake inhibitor) and 28.6% reported undergoing professional healthcare assistance. 
Conclusion: Self-injury is a prevalent behavior in adolescents, that potentially results in psychological and physical impairments. Further research to achieve a better understanding of clinical and epidemiological features of self-injury is essential so that more effective preventive and therapeutic interventions can be developed to target the needs of young people worldwide.