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. 2023 Feb;53(3):875-886.
doi: 10.1017/S0033291721002245. Epub 2021 Jun 18.

Non-suicidal self-injury among first-year college students and its association with mental disorders: results from the World Mental Health International College Student (WMH-ICS) initiative

Glenn Kiekens  1   2   3 , Penelope Hasking  4 , Ronny Bruffaerts  1   5 , Jordi Alonso  6   7   8 , Randy P Auerbach  9 , Jason Bantjes  10 , Corina Benjet  11 , Mark Boyes  4 , Wai Tat Chiu  12 , Laurence Claes  2   13 , Pim Cuijpers  14 , David D Ebert  15 , Arthur Mak  16 , Philippe Mortier  6   7 , Siobhan O'Neill  17 , Nancy A Sampson  12 , Dan J Stein  18 , Gemma Vilagut  6   7 , Matthew K Nock  19 , Ronald C Kessler  12 ; WHO World Mental Health International College Student (WMH-ICS) collaborators
Affiliations

Non-suicidal self-injury among first-year college students and its association with mental disorders: results from the World Mental Health International College Student (WMH-ICS) initiative

Glenn Kiekens et al. Psychol Med. 2023 Feb.

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.

Keywords: Adolescence; college students; emerging adulthood; mental disorders; non-suicidal self-injury.

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Conflict of interest statement

Disclosures/Conflicts of Interest

Dr. Auerbach serves on the scientific advisory board for Ksana Health. Dr. Ebert reports to have received consultancy fees/served on the scientific advisory board for Sanofi, Novartis, Minddistrict, Lantern, Schoen Kliniken, and two German health insurance companies (BARMER, Techniker Krankenkasse). He is also a stakeholder in the Institute for health training online (GET.ON), which aims to implement scientific findings related to digital health interventions into routine care. In the past 3 years, Dr. Kessler was a consultant for Datastat, Inc., Holmusk, RallyPoint Networks, Inc., and Sage Therapeutics. He has stock options in Mirah, PYM, and Roga Sciences.

Figures

Figure 1.
Figure 1.
Hazard rate and cumulative age-of-onset distribution for non-suicidal self-injury in WMH-ICS. Note: Projected age of onset are based on first-year students, limiting the representativeness of the estimated distributions above age 18 to 19 years (i.e., the typical age of entering college).
See this image and copyright information in PMC

References

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