| Abstract [eng] |
Self-injurious behaviour in adolescence is a significant public health problem associated with increasing prevalence and an elevated risk of suicidal behaviour. In Europe, self-harm remains one of the leading causes of youth mortality, and Lithuania demonstrates particularly high rates. In light of these trends, it is important to analyse the clinical course of self-injury and its associated biopsychosocial factors in an inpatient child and adolescent psychiatry sample. The aim of this thesis was to determine the causes, prevalence, clinical course, and biopsychosocial correlates of self-injurious behaviour in an inpatient child and adolescent psychiatry population and to evaluate the clinical significance of these factors. Research methods: A retrospective analysis of medical records was conducted, including 413 patients (aged 10–17 years) treated at the University Child and Adolescent Psychiatry Unit of the Republican Vilnius Psychiatric Hospital between 2022 and 2025. A total of 733 hospitalisations were recorded. Data extracted from medical records included sociodemographic variables (age, sex), psychiatric diagnoses, information on self-injury and suicidal intent, childhood experiences, family status and environment, academic performance, extracurricular activities, and substance use. Statistical analysis was performed using Microsoft Excel and R-Commander software. Pearson’s chisquare test and the Mann–Whitney U test were applied. Results were considered statistically significant at p < 0.05. Research results: The study found that self-injurious behaviour was a common phenomenon in the inpatient child and adolescent psychiatric setting, with a substantial proportion of adolescents exhibiting recurrent self-harm. The onset of self-harm most frequently occurred in early to mid adolescence and often developed into a recurring behavior associated with a more complex clinical course and greater treatment needs. Analysis of biopsychosocial factors revealed that self-harm was most strongly associated with mood disorders. Adolescents in this group were more likely to experience both initial and recurrent episodes of self-harm, whereas some other diagnostic groups demonstrated a lower prevalence of self-harm. Significant gender differences indicated that females engaged in self-harm more frequently than males, and recurrent self-harm was also more characteristic of females. Recurrent self-injurious behaviour was found to be associated with an increased risk of suicidal behaviour and may be considered an important prognostic marker for identifying a higher-risk clinical population. The findings confirm that self-harm is a multifactorial phenomenon arising from the complex interaction of biopsychosocial factors and requiring early risk identification and targeted interventions. Conclusions: Self-harm in the population of a child and adolescent psychiatric inpatient unit was a common and often recurrent phenomenon, shaped by the interaction of biological, psychological, and social factors. It was most strongly associated with female gender and affective disorders, while adverse childhood experiences and psychosocial difficulties constituted a significant risk context. The findings highlight the importance of comprehensive biopsychosocial assessment and the need for systematic evaluation of risk factors in clinical practice. |
