ArticleBMC psychiatry2026
Clinical characteristics associated with non-suicidal self-injury among Japanese adolescents-relationship between non suicidal self-injury and psychosomatic symptoms: a retrospective cross-sectional study.
Article in BMC psychiatry, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundNon-suicidal self-injury (NSSI) is an intentional but non-lethal form of bodily harm inflicted upon oneself. Difficulties in identifying and expressing emotions may underlie psychosomatic symptoms and self-harm. However, the relationship between NSSI and psychosomatic symptoms remains unclear. This study examined demographic and clinical factors associated with NSSI among Japanese adolescents.
methodsThis retrospective cross-sectional study included 485 adolescent outpatients in a Japanese psychiatric setting between July 2019 and May 2021 (mean age 14.64 ± 1.65 years; 248 boys and 237 girls). NSSI and related clinical features were assessed using diagnostic interviews and self-report questionnaires. Psychosomatic symptoms were categorized according to clinician judgment, reflecting routine clinical practice. Patients with insufficient information, intellectual disabilities, or a history of suicide attempts or indirect self-harm (e.g., substance abuse, eating disorders, or risk-taking behaviors) were excluded. Multiple logistic regression analyses were conducted to identify associative, rather than causal, factors related to NSSI.
resultsOf the 417 adolescents included in the analysis, 59 (12.2%) engaged in NSSI. Logistic regression identified six factors significantly associated with NSSI: female sex(OR = 3.05, 95% CI: 1.51-6.16, p =.002), fewer psychosomatic symptoms (OR = 0.44, 95% CI: 0.24-0.82, p =.01), a history of being bullied (OR = 2.14, 95% CI: 1.03-4.41, p =.04), no family history of psychiatric disorders (OR = 0.40, 95% CI: 0.18-0.86, p =.02), depressive symptoms (OR = 1.08, 95% CI: 1.02-1.15, p =.013), and suicidal thoughts (OR = 2.13, 95% CI: 1.05-4.32, p =.037). No multicollinearity concerns were observed (all VIF < 1.5).
conclusionsAdolescents who engaged in NSSI exhibited fewer clinician-assessed psychosomatic symptoms than those who did not engage in NSSI. Several factors, including female sex, fewer psychosomatic symptoms, bullying experiences, family history of psychiatric disorders, depressive symptoms, and suicidal thoughts, were associated with NSSI. These findings underscore the importance of screening for NSSI, even among adolescents who present with minimal physical complaints. CLINICAL TRIAL NUMBER: Not applicable.
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