Editorial: Suicidality and Self-Injury Behaviours Across the Lifespan in Mental and Substance Use Disorders

Rūta Karaliūnienė¹Ramdas Sarjerao Ransing²Laura Orsolini^3*

• ¹Rhein-Mosel-Fachklinik Clinic, Landeskrankenhaus Andernach, Academic Hospital at Johannes Gutenberg, University Mainz, Andernach, 56626, Germany
• ²All India Institute of Medical Sciences Guwahati, Guwahati, India
• ³Department of Experimental and Clinical Medicine, Faculty of Medicine and Surgery, Marche Polytechnic University, Ancona, Italy

Suicidality and self-injury continue to represent significant challenges worldwide, particularly among individuals affected by mental health and substance use disorders. These behaviors are complex and multifaceted, influenced by an interplay of biological, psychological, and social factors that evolve across developmental stages and cultural contexts. The collection of articles presented in this Frontiers in Psychiatry Research Topic provides timely and valuable insights into these critical phenomena, exploring underlying mechanisms, risk factors, and potential avenues for intervention.A prominent theme emerging from this Research Topic is the nuanced relationship between non-suicidal self-injury (NSSI) and suicidal behavior. While these behaviors are related, they present distinct clinical features and trajectories, requiring careful differentiation and targeted approaches for prevention and treatment.For example, a population-based study from South Korea by Kim et al.1 (accepted, 2025) highlights the association between smoking status and suicidal ideation, planning, and attempts. This research underscores the importance of integrating behavioral health factors into suicide prevention strategies and the need to address modifiable lifestyle risks in public health initiatives.Adolescence is identified as a particularly vulnerable period in several contributions. Zhu et al.2 (2024) developed a predictive model to identify adolescents at elevated risk for NSSI within six months following psychiatric hospitalization, emphasizing the critical window for early intervention. Complementing this, XXu et al. (2024) demonstrated through a longitudinal analysis that NSSI can both precede and result from suicidal ideation among youths, revealing a reciprocal relationship that challenges traditional linear models of risk3. These findings highlight the importance of continuous monitoring and individualized support in clinical practice.Advances in neuroimaging enhance our understanding of the biological underpinnings of suicidality. Tymofiyeva et al. (2024) focus on resting-state functional connectivity of the putamen in depressed adolescents with a history of suicide attempts, identifying potential biomarkers that may inform future personalized treatment approaches4. In parallel, Orsolini et al. (2024) investigated social cognitive deficits, particularly impairments in Theory of Mind, in youths transitioning from NSSI to suicide attempts. Their study suggests that difficulties in understanding others’ mental states may contribute to the progression toward suicidal behavior.The role of digital environments in shaping self-injurious behavior is increasingly recognized. Orsolini et al. (2024) explored how online interactions may influence NSSI among young people, highlighting both risks and opportunities inherent in social media use5. Their findings call for the development of innovative prevention strategies that engage youth within digital contexts.From a diagnostic perspective, two articles critically assessed the DSM-5 criteria for suicidal behavior and NSSI disorders. Oliogu et al. (2024) provided a comprehensive review of the clinical utility, pathophysiology, and treatment options associated with suicidal behavior disorder6, while Dierick et al. (2023) compared patterns of NSSI engagement and severity among emerging adults7. These contributions are vital as the field seeks consensus on diagnostic boundaries and subsequent clinical management.Cultural and social factors also play a significant role in suicidality and self-injury. Meisler et al. (2023) examined NSSI and mental health among female Arab minority students, revealing how identity conflict and acculturation stress shape these behaviors8. Their work underscores the need for culturally sensitive interventions tailored to diverse populations.Finally, Pato et al. (2024) focused on an often-overlooked group - prisoners, investigating suicidal behavior through the lens of behavioral addiction9. Their study broadens understanding of risk factors and mechanisms associated with suicidality in incarcerated populations.Overall, these studies clearly illustrated the multifaceted nature of suicidality and self-injury, shaped by developmental, neurobiological, psychosocial, and cultural influences. All these studies pointed out the need for integrated and multidisciplinary approaches since the assessment phase, as well as a tailored diagnostic and treatment approach which need to be adapted across different ages and target populations.This Research Topic not only advances knowledge but also identifies important gaps for future inquiry. Longitudinal studies to clarify causality, refinement of neurobiological markers, and the development of culturally attuned, evidence-based prevention and treatment programs should be prioritized.As the global burden of suicide and self-injury persists, especially among individuals with mental health and substance use disorders, this collection offers a valuable framework for clinicians, researchers, and policymakers seeking to reduce harm and save lives throughout the lifespan.