About 1 in 5 Adolescent Girls Have Engaged in Non-Suicidal Self-Injury

The global prevalence of non-suicidal self-injury is twice as high among adolescent girls than adolescent boys, according to results of a meta-analysis published in JAMA Network Open.

A wealth of evidence indicates that non-suicidal self-injury is a robust predictor of suicidality and mortality by suicide. Although non-suicidal self-injury is more frequently reported among girls and women than boys and men, relatively little is known about geographic variability in the prevalence of, and potential sex difference in, non-suicidal self-injury. To address this knowledge gap, investigators conducted a systematic review and meta-analysis to evaluate the global prevalence of non-suicidal self-injury among adolescent girls vs adolescent boys.

The investigators searched publication databases for studies published in English between January 1, 2000 and May 10, 2022. Studies that examined sex differences in self-injury (explicitly defined as behaviors occurring without suicidal intent) among adolescents between 10 and 19 years of age. The investigators extracted and quantitatively pooled prevalence data, conducted a random-effects meta-analysis, and performed post hoc analyses to assess regional variation in the prevalence of non-suicidal self-injury according to sex.

A total of 38 studies were included in the analysis, for a pooled sample size of 266,491 participants across 17 countries. The studies were conducted in Asia (k=14), North America (k=11), Europe (k=8), and Australia (k=1).

The investigators found that the pooled prevalence of non-suicidal self-injury across regions was 21.4% (95% CI, 21.2%-21.7%) for girls and 13.7% (95% CI 13.5%-13.9%) for boys. Prevalence varied by region, as non-suicidal self-injury was substantially higher among adolescent girls than adolescent boys in North America (20.2% vs 8.9%; odds ratio [OR], 2.49; 95% CI, 2.16-2.86), Europe (19.4% vs 12.6%; OR, 2.08; 95% CI, 1.69-2.58), and Australia (18.8% vs 16.8%; OR, 1.15; 95% CI, 0.94-1.42). However, prevalence rates were not significantly different between girls (24.1%) and boys (24.8%; OR, 1.00; 95% CI, 0.71-1.41) in Asia.

In post hoc analyses, the investigators observed no significant regional differences in the prevalence of non-suicidal self-injury among adolescent girls. However, the prevalence rates among adolescent boys were significantly higher in Asia relative to North America (P =.003) and Europe (P =.02).

These findings indicate that non-suicidal self-injury is generally more prevalent among adolescent girls than adolescent boys, and there are significant regional differences in the prevalence of non-suicidal self-injury among adolescent boys. The investigators concluded, “Research in this area will be foundational in developing and evaluating effective interventions for all adolescents engaged in [non-suicidal self-injury] regardless of location and sex.” The primary limitations of the study include the heterogeneity of study designs, as well as variable definitions of non-suicidal self-injury. Additionally, the included studies may not have accounted for gender identity.

This article originally appeared on Psychiatry Advisor