Clinical and psychological profiles of patients with different patterns of nonsuicidal self-injury

MIkhail Zinchuk^1*Georgii Kustov¹Ilya Mihsin¹Sofya Popova¹Ekaterina Sviatskaia¹Alexander Yakovlev^1,2Alla Guekht^1,3

• ¹Moscow Research and Clinical Center for Neuropsychiatry, Moscow, Russia
• ²Institute of Higher Nervous Activity and Neurophysiology, Russian Academy of Sciences, Moscow, Russia
• ³Pirogov Russian National Research Medical University, Moscow, Moscow Oblast, Russia

Suicide is a significant public health problem worldwide, especially in Eastern European countries. Previous studies have shown that nonsuicidal self-injury (NSSI) is a significant risk factor for suicide attempts, particularly among people with mental health conditions. However, the risk of adverse outcomes, including suicide, likely varies among NSSI subtypes. The aim of this study was to evaluate the relationships between NSSI parameters and clinical and psychological variables in Russian patients with non-psychotic mental disorders and suicidal ideation. The study sample consisted of 614 consecutive patients (mean age: 24.9 years; 84% female). The Inventory of Statements About Self-Injury-I (ISAS-I) was used to evaluate NSSI parameters. The data were clustered based on the method and frequency of NSSI. The relationships between these patterns and other NSSI parameters (age at NSSI onset, experience of physical pain during NSSI), clinical characteristics (anxiety and depression levels, psychiatric diagnosis), psychological profiles and quality of life were evaluated. More than 94% of patients practiced NSSI with more than one method, with cutting, scratching, and banging being the most common. Cluster analysis identified three subtypes of NSSI. Patients who engaged in NSSI more frequently and in a greater variety of ways were more likely to attempt suicide (lifetime suicide attempt rate: 60.9%). These participants also exhibited more severe clinical symptoms, scored higher on most pathological personality traits, demonstrated less resilience to suicide, and experienced a lower quality of life. Our findings underscore the importance of providing a high level of clinical attention to individuals with mental health conditions who frequently engage in NSSI using various methods. The significant differences observed in many of the studied parameters between the other two clusters highlight the importance of further research into categorizing NSSI behavior. Such research could lead to more accurate prognoses for NSSI patients and form the basis for developing targeted therapies.