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Nathan Lowry, Winner of the 2021 NIMH Three-Minute Talks Competition


NATHAN LOWRY: Hi, my name is Nathan Lowry and today I'm excited to share my project: Non-Suicidal Self-Injury and Suicide Risk Among Adult Medical Inpatients. 

In 2019, suicide was the 10th leading cause of death in the United States, claiming the lives of over 47,000 people. One risk factor for suicide is non-suicidal self-injury, which I'll refer as NSSI. NSSI is when an individual deliberately harms themselves without the intent to die. And NSSI has been found to be a risk factor for suicide among both youth and adults.

However, research on adults is limited compared to youth. Specifically, research on the association between suicide and NSSI is particularly limited among adult medical inpatients who are a population at increased risk for suicide. To bridge this gap in research, we aimed to describe the relationship between a lifetime history of NSSI and suicide risk among an adult medical inpatient population.

This study was a sub-analysis of a larger multi-site instrument validation study, which included adult medical inpatients aged 18 or older. A single item, "Have you ever done anything to purposely hurt yourself without wanting to die. For example, cutting or burning yourself?" Was used to assess a lifetime history of NSSI. Additional follow-up questions asked about NSSI severity, recency, and methods in the ASQ Suicide Screening Questionnaire tool, a brief four-item instrument was used to assess suicide risk.

A total of 727 adults were included in the sample. Among those with a history of NSSI, 27% reported receiving medical treatment for their injuries and 31% indicated that they had engaged in NSSI within the past year. Consistent with previous research, cutting was the most common method of NSSI found in the sample. Logistic regression revealed that compared to adult medical inpatients without a history of NSSI, adult medical patients with a history of NSSI were 11 times more likely to screen positive for suicide risk.

These findings are significant for a number of reasons. First, individuals with a lifetime history of NSSI were significantly more likely to screen positive for suicide risk, providing further evidence that NSSI is a potent risk factor for suicide among medically ill adults. Additionally, almost a third of individuals who reported a lifetime history of NSSI indicated that they had engaged in NSSI within the past year, suggesting that NSSI is clinically relevant among adult medical patients.

While research on NSSI has primarily focused on youth, the strong association between suicide risk and NSSI found in this study promotes the need for future research to examine NSSI among adult medical inpatients to better inform suicide detection and prevention efforts. 

Thank you.