Glenn Kiekens1,2,3, Penelope Hasking4, Ronny Bruffaerts1,5, Jordi Alonso6,7,8, Randy P Auerbach9, Jason Bantjes10, Corina Benjet11, Mark Boyes4, Wai Tat Chiu12, Laurence Claes2,13, Pim Cuijpers14, David D Ebert15, Arthur Mak16, Philippe Mortier6,7, Siobhan O'Neill17, Nancy A Sampson12, Dan J Stein18, Gemma Vilagut6,7, Matthew K Nock19, Ronald C Kessler12. 1. Center for Public Health Psychiatry, KU Leuven, Leuven, Belgium. 2. Faculty of Psychology and Educational Sciences, KU Leuven, Leuven, Belgium. 3. Center for Contextual Psychiatry, KU Leuven, Leuven, Belgium. 4. School of Population Health, Curtin University, Perth, Australia. 5. Institute for Social Research, Population Studies Center, University of Michigan, Ann Arbor, Michigan, USA. 6. Health Services Research Unit, IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain. 7. CIBER en Epidemiología y Salud Pública, Madrid, Spain. 8. Pompeu Fabra University, Barcelona, Spain. 9. Department of Psychiatry, Columbia University, New York, USA. 10. Department of Global Health, Institute for Life Course Health Research, Faculty of Medicine and Health Sciences, Stellenbosch University, Stellenbosch, South Africa. 11. Department of Epidemiologic and Psychosocial Research, National Institute of Psychiatry Ramón de la Fuente Muñiz, Mexico City, Mexico. 12. Department of Health Care Policy, Harvard Medical School, Boston, MA, USA. 13. Faculty of Medicine and Health Sciences (CAPRI), University of Antwerp, Antwerp, Belgium. 14. Department of Clinical, Neuro and Developmental Psychology, Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands. 15. Department for Sport and Health Sciences, Chair for Psychology & Digital Mental Health Care, Technical University Munich, Munich, Germany. 16. Department of Psychiatry, The Chinese University of Hong Kong, Hong Kong, Hong Kong SAR. 17. School of Biomedical Sciences, Ulster University, Derry-Londonderry, Northern Ireland. 18. Department of Psychiatry and Mental Health and South African Medical Council Research Unit on Risk and Resilience in Mental Disorders, University of Cape Town and Groote Schuur Hospital, Cape Town, South Africa. 19. Department of Psychology, Harvard University, Cambridge, MA, USA.
Abstract
BACKGROUND: Although non-suicidal self-injury (NSSI) is an issue of major concern to colleges worldwide, we lack detailed information about the epidemiology of NSSI among college students. The objectives of this study were to present the first cross-national data on the prevalence of NSSI and NSSI disorder among first-year college students and its association with mental disorders. METHODS: Data come from a survey of the entering class in 24 colleges across nine countries participating in the World Mental Health International College Student (WMH-ICS) initiative assessed in web-based self-report surveys (20 842 first-year students). Using retrospective age-of-onset reports, we investigated time-ordered associations between NSSI and Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-IV) mood (major depressive and bipolar disorder), anxiety (generalized anxiety and panic disorder), and substance use disorders (alcohol and drug use disorder). RESULTS: NSSI lifetime and 12-month prevalence were 17.7% and 8.4%. A positive screen of 12-month DSM-5 NSSI disorder was 2.3%. Of those with lifetime NSSI, 59.6% met the criteria for at least one mental disorder. Temporally primary lifetime mental disorders predicted subsequent onset of NSSI [median odds ratio (OR) 2.4], but these primary lifetime disorders did not consistently predict 12-month NSSI among respondents with lifetime NSSI. Conversely, even after controlling for pre-existing mental disorders, NSSI consistently predicted later onset of mental disorders (median OR 1.8) as well as 12-month persistence of mental disorders among students with a generalized anxiety disorder (OR 1.6) and bipolar disorder (OR 4.6). CONCLUSIONS: NSSI is common among first-year college students and is a behavioral marker of various common mental disorders.
BACKGROUND: Although non-suicidal self-injury (NSSI) is an issue of major concern to colleges worldwide, we lack detailed information about the epidemiology of NSSI among college students. The objectives of this study were to present the first cross-national data on the prevalence of NSSI and NSSI disorder among first-year college students and its association with mental disorders. METHODS: Data come from a survey of the entering class in 24 colleges across nine countries participating in the World Mental Health International College Student (WMH-ICS) initiative assessed in web-based self-report surveys (20 842 first-year students). Using retrospective age-of-onset reports, we investigated time-ordered associations between NSSI and Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-IV) mood (major depressive and bipolar disorder), anxiety (generalized anxiety and panic disorder), and substance use disorders (alcohol and drug use disorder). RESULTS: NSSI lifetime and 12-month prevalence were 17.7% and 8.4%. A positive screen of 12-month DSM-5 NSSI disorder was 2.3%. Of those with lifetime NSSI, 59.6% met the criteria for at least one mental disorder. Temporally primary lifetime mental disorders predicted subsequent onset of NSSI [median odds ratio (OR) 2.4], but these primary lifetime disorders did not consistently predict 12-month NSSI among respondents with lifetime NSSI. Conversely, even after controlling for pre-existing mental disorders, NSSI consistently predicted later onset of mental disorders (median OR 1.8) as well as 12-month persistence of mental disorders among students with a generalized anxiety disorder (OR 1.6) and bipolar disorder (OR 4.6). CONCLUSIONS: NSSI is common among first-year college students and is a behavioral marker of various common mental disorders.
Entities:
Keywords:
Adolescence; college students; emerging adulthood; mental disorders; non-suicidal self-injury
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