Evidence map›Paper›PMID 29397445›Full record

SynthesisEuropean child & adolescent psychiatry2019

Population attributable risk of factors associated with the repetition of self-harm behaviour in young people presenting to clinical services: a systematic review and meta-analysis.

Katrina Witt, Allison Milner, Matthew J Spittal, Sarah Hetrick, Jo Robinson, Jane Pirkis, Gregory Carter

Registry-linked trialAbstract readMeta-AnalysisSystematic Review
PubMed Publisher
In one paragraph

Synthesis in European child & adolescent psychiatry, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT07450105 (Intensive Dialectical Behavior Therapy for Self-Harm and Suicidal Behavior in Youth), which is not on this map. Cited by 33 papers, 5 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
33citing papers in PubMed, 5 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT07450105 naenrolling by invitationnot on this mapstarted 2026, after this paper: background citation

Intensive Dialectical Behavior Therapy for Self-Harm and Suicidal Behavior in Youth: A Pilot Study

TypeinterventionalSponsorHaukeland University HospitalRan2026 to 2027Enrolled12ConditionsSelf-Harm, Deliberate, Suicidal Behavior, Borderline Personality Disorder (BPD)ArmsIntensive Dialectical Behavior Therapy
3 · Its place in the literature

Who cites it

33 citing papers in PubMed, 5 syntheses or guidelines pooled it.

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  4. Interventions for self-harm in children and adolescents.The Cochrane database of systematic reviews · 2021
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors.

Katrina WittTurning Point, Eastern Health Clinical School, Monash University, Fitzroy, Australia. katrina.witt@monash.edu.
Allison MilnerCentre for Health Equity, School of Population and Global Health, University of Melbourne, Melbourne, Australia.
Matthew J SpittalMelbourne School of Population and Global Health, University of Melbourne, Melbourne, Australia.
Sarah HetrickCentre for Youth Mental Health, University of Melbourne, Melbourne, Australia.
Jo RobinsonOrygen, the National Centre of Excellence in Youth Mental Health and the Centre for Youth Mental Health, University of Melbourne, Melbourne, Australia.
Jane PirkisMelbourne School of Population and Global Health, University of Melbourne, Melbourne, Australia.
Gregory CarterCentre for Brain and Mental Health Research, Faculty of Health and Medicine, University of Newcastle, Melbourne, Australia.

Funding

American Foundation for Suicide Prevention PDF-0-145-16Auckland Medical Research Foundation Goodfellow Repatriation FellowshipNational Health and Medical Research Council Early Career FellowshipNational Health and Medical Research Council Senior Research FellowshipVictorian Department of Health and Human Services C4892
6 · The paper itself

Abstract

The repetition of hospital-treated self-harm by young people is common. However, little work has summarised the modifiable factors associated with this. A thorough understanding of those factors most strongly associated with repetition could guide the development of relevant clinical interventions. We systematically reviewed four databases (EMBASE, Medline, PubMed and PsycINFO) until 15 April 2016 to identify all observational studies of factors for the repetition of self-harm or suicide reattempts (together referred to as 'self-harm behaviour') in young people. We quantified the magnitude of association with odds ratios (OR) and 95% confidence intervals (CIs) and calculated the population attributable risk (PAR) and population preventable fraction (PPF) for modifiable factors to provide an indication of the potential impact in reducing subsequent self-harm behaviour in this population. Seventeen studies were included comprising 10,726 participants. Borderline personality disorder (OR 3.47, 95% CI 1.84-6.53; PAR 42.4%), any personality disorder (OR 2.54, 95% CI 1.71-3.78; PAR 16.3%), and any mood disorder (OR 2.16, 95% CI 1.09-4.29; PAR 42.2%) are important modifiable risk factors. Severity of hopelessness (OR 2.95, 95% CI 1.74-5.01), suicidal ideation (OR 2.01, 95% CI 1.43-2.81), and previous sexual abuse (OR 1.52, 95% CI 1.02-2.28; PAR 12.8%) are also associated with repetition of self-harm. We recommend that clinical services should focus on identifying key modifiable risk factors at the individual patient level, whilst the reduction of exposure to child and adolescent sexual abuse would also be a useful goal for public health interventions.

Indexed as

AdolescentAdultChildFemaleHumansMaleRisk FactorsSelf-Injurious BehaviorYoung AdultAdolescentsChildrenSelf-harmSuicideYoung people

Identifiers

PMID29397445

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.