OBJECTIVE
To study age patterns of changes in the leading clinical diagnosis in adolescents and young people with non-suicidal self-harm.
MATERIAL AND METHODS
Two hundred female (n=182, 91.0%) and male (n=18, 9.0%) adolescents and young adults were examined. The clinical method (standard diagnostic interview) was used; statistical processing of the results was performed using the SPSS (Statistical Package for the Social Sciences) software.
RESULTS
Non-suicidal self-harm was observed in 8 main nosological forms: adaptation disorders (39.5%), behavior disorders (21.0%), personality disorders (10.5%), eating disorder (10.5%), obsessive-compulsive disorder (OCD) (6.5%), including combined with the so-called «OCD spectrum» (hoarding, skin excoriations, trichotillomania) (4.0%), schizophrenic spectrum disorders (6.5%), depressive episode (4.0%), and organic non-psychotic disorders (1.5%). The initial diagnosis of adaptation disorder at the second examination in all patients was replaced by others (n=79, 100.0%): in 28 cases (35.4%) it was transformed into a «behavioral» diagnosis, and in 51 cases (64.5%), in persons over 18 years of age, into a diagnosis of personality disorders. At the final examination, a statistically significant decrease was found in the number of patients diagnosed with F91—92: 33.5% versus 8.0% (χ²=39.542, df(1), p=0.0001, OR=5.793, CI 95% (3.214—10.443)), which is also explained by these patients reaching adulthood and, therefore, the possibility of making a diagnosis of personality disorders. Thus, its prevalence significantly increased from 37.5% to 68.0%, χ²=39.967, df(1), p=0.0001, OR=5.114, CI 95% (2.995—8.733). Of note, all 13 patients (6.5%) with the primary diagnosis of obsessive-compulsive disorder had their diagnoses discarded and replaced with anankastic personality disorder in 8 cases (4.0%) and with F91—92 in 5 cases (2.5%) (for persons under 18 years of age). Analysis of final diagnoses indicates a numerical predominance of patients with personality disorders compared to the total number of patients with other diagnoses: 136 versus 64 subjects (χ²=25.920, df(1), p=0.0001). Of these, 60 (30.0% of the total number of patients) were patients with borderline personality disorder. In addition, «borderline features» were always present in the characterological structure of mixed and other personality disorders (F61), accounting for 16.5% of all diagnoses.
CONCLUSION
The established patterns regarding the structure and change of the main clinical diagnoses in the examined patients are important for understanding both the nosological affiliation of the non-suicidal self-harm and for clarifying the development stages of some types of personality disorders in adolescents.
