Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

  • Systematic Review
  • Published:

What are the correlates of non-suicidal self-injury in children and adolescents? An umbrella systematic review of global evidence

Molecular Psychiatry (2026)Cite this article

Subjects

Abstract

Background

Non-suicidal self-injury (NSSI) persists as a major public health challenge worldwide. Identifying and strategically targeting risk factors for NSSI constitutes a practical approach to its prevention. We aim to synthesize existing knowledge concerning the range and magnitude of risk factors for NSSI among children and adolescents, and to critically assess the robustness of the available evidence.

Methods

In this umbrella review, six bibliographic databases were systematically searched for articles published from database inception to Dec 2024. For the assessment of evidence credibility, pre-specified criteria for classifying evidence were utilized, categorized as convincing (“class I”), highly suggestive (“class II”), suggestive (“class III”), weak (“class IV”), or no evidence (“class V”). The Amstar-2 framework was employed to evaluate the quality of the evidence which graded as “high,” “moderate,” “low,” or “critically low” quality.

Results

The study included meta-analyses of observational studies in the past 30 years on risk factors for NSSI in children and adolescents. We identified 16 meta-analyses comprising 410 primary studies on 43 risk factors from 38 countries, involving 2,659,156 children and adolescents. Twenty-three (e.g. LGBTIQ) risk factors were categorized as individual, followed by family level (n = 8, e.g. childhood maltreatment), school/peer level (n = 8, e.g. bully victims) and multifactorial level (n = 4, e.g. no religion). Eighteen (41.86%) risk factors provided highly suggestive (Class II) evidence of association with NSSI. Suggestive evidence (class III) indicated that NSSI was associated with adverse childhood experiences (2.31, 1.77–3.01) and being left-behind children (1.37, 1.11–1.69).

Conclusion

A multitude of risk factors spanning diverse domains were identified, highlighting the multifactorial nature of NSSI in adolescents and children. Comprehensive prevention strategies and measures should be conducted for children and adolescents to decrease the risk of NSSI and associated harms in multilevel approaches.

This is a preview of subscription content, access via your institution

Access options

Buy this article

  • Purchase on SpringerLink
  • Instant access to the full article PDF.

USD 39.95

Prices may be subject to local taxes which are calculated during checkout

Fig. 1: Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) flowchart.
Fig. 2: Forest plot of risk factors for NSSI in adolescents and children, by domain.
Fig. 3: Overall quality assessment of risk factors.

Similar content being viewed by others

References

  1. Moran P, Chandler A, Dudgeon P, Kirtley OJ, Knipe D, Pirkis J, et al. The lancet commission on self-harm. Lancet. 2024;404:1445–92.

    Article  PubMed  Google Scholar 

  2. GBD 2019 Mental Disorders Collaborators. Global, regional, and national burden of 12 mental disorders in 204 countries and territories, 1990-2019: a systematic analysis for the Global Burden of Disease Study 2019. Lancet Psychiatry. 2022;9:137–50.

    Article  Google Scholar 

  3. GBD 2019 Diseases and Injuries Collaborators. Global burden of 369 diseases and injuries in 204 countries and territories, 1990-2019: a systematic analysis for the Global Burden of Disease Study 2019. Lancet. 2020;396:1204–22.

    Article  Google Scholar 

  4. Castelpietra G, Knudsen AKS, Agardh EE, Armocida B, Beghi M, Iburg KM, et al. The burden of mental disorders, substance use disorders and self-harm among young people in Europe, 1990–2019: findings from the Global Burden of Disease Study 2019. Lancet Reg Health Eur. 2022;16:100341.

    Article  PubMed  PubMed Central  Google Scholar 

  5. GBD 2017 Child and Adolescent Health Collaborators, Reiner RC, Olsen HE, Ikeda CT, Echko MM, Ballestreros KE, et al. Diseases, injuries, and risk factors in child and adolescent health, 1990–2017: findings from the global burden of diseases, injuries, and risk factors 2017 study. JAMA Pediatr. 2019;173:e190337.

    Article  Google Scholar 

  6. Hawton K, Saunders KE, O’Connor RC. Self-harm and suicide in adolescents. Lancet. 2012;379:2373–82.

    Article  PubMed  Google Scholar 

  7. Skegg K. Self-harm. Lancet. 2005;366:1471–83.

    Article  PubMed  Google Scholar 

  8. Brunner R, Kaess M, Parzer P, Fischer G, Carli V, Hoven CW, et al. Life-time prevalence and psychosocial correlates of adolescent direct self-injurious behavior: a comparative study of findings in 11 European countries. J Child Psychol Psychiatry. 2014;55:337–48.

    Article  PubMed  Google Scholar 

  9. Hawton K, James A. Suicide and deliberate self harm in young people. BMJ. 2005;330:891–4.

    Article  PubMed  PubMed Central  Google Scholar 

  10. Muehlenkamp JJ, Claes L, Havertape L, Plener PL. International prevalence of adolescent non-suicidal self-injury and deliberate self-harm. Child Adolesc Psychiatry Ment Health. 2012;6:10.

    Article  PubMed  PubMed Central  Google Scholar 

  11. Xiao Q, Song X, Huang L, Hou D, Huang X. Global prevalence and characteristics of non-suicidal self-injury between 2010 and 2021 among a non-clinical sample of adolescents: a meta-analysis. Front Psychiatry. 2022;13:912441.

    Article  PubMed  PubMed Central  Google Scholar 

  12. Griffin E, McMahon E, McNicholas F, Corcoran P, Perry IJ, Arensman E. Increasing rates of self-harm among children, adolescents and young adults: a 10-year national registry study 2007-2016. Soc Psychiatry Psychiatr Epidemiol. 2018;53:663–71.

    Article  PubMed  Google Scholar 

  13. Hawton K, Witt KG, Salisbury TLT, Arensman E, Gunnell D, Hazell P, et al. Psychosocial interventions following self-harm in adults: a systematic review and meta-analysis. Lancet Psychiatry. 2016;3:740–50.

    Article  PubMed  Google Scholar 

  14. Kiekens G, Claes L, Demyttenaere K, Auerbach RP, Green JG, Kessler RC, et al. Lifetime and 12-Month nonsuicidal self-injury and academic performance in college freshmen. Suicide Life Threat Behav. 2016;46:563–76.

    Article  PubMed  Google Scholar 

  15. Gulbas LE, Hausmann-Stabile C, De Luca SM, Tyler TR, Zayas LH. An exploratory study of nonsuicidal self-injury and suicidal behaviors in adolescent Latinas. Am J Orthopsychiatry. 2015;85:302–14.

    Article  PubMed  PubMed Central  Google Scholar 

  16. Hamza CA, Willoughby T. Nonsuicidal self-injury and suicidal risk among emerging adults. J Adolesc Health. 2016;59:411–5.

    Article  PubMed  Google Scholar 

  17. Robinson K, Garisch JA, Kingi T, Brocklesby M, O’Connell A, Langlands RL, et al. Reciprocal risk: the longitudinal relationship between emotion regulation and non-suicidal self-injury in adolescents. J Abnorm Child Psychol. 2019;47:325–32.

    Article  PubMed  Google Scholar 

  18. Knipe D, Padmanathan P, Newton-Howes G, Chan LF, Kapur N. Suicide and self-harm. Lancet. 2022;399:1903–16.

    Article  PubMed  Google Scholar 

  19. Bronfenbrenner U Ecological systems theory. Greenwich, CT: JAI. 1989.

  20. Kiekens G, Claes L, Hasking P, Mortier P, Bootsma E, Boyes M, et al. A longitudinal investigation of non-suicidal self-injury persistence patterns, risk factors, and clinical outcomes during the college period. Psychol Med. 2023;53:6011–26.

    Article  PubMed  Google Scholar 

  21. Wu B, Zhang H, Chen J, Chen J, Liu Z, Cheng Y, et al. Potential mechanisms of non-suicidal self-injury (NSSI) in major depressive disorder: a systematic review. Gen Psychiatr. 2023;36:e100946.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  22. Hu C, Jiang W, Wu Y, Wang M, Lin J, Chen S, et al. Microstructural abnormalities of white matter in the cingulum bundle of adolescents with major depression and non-suicidal self-injury. Psychol Med. 2024;54:1113–21.

    Article  PubMed  Google Scholar 

  23. Chen X, Xu J, Wang X, Qiu Y, Yang R, Wang Z, et al. Mediating role of anxiety and impulsivity in the association between child maltreatment and lifetime non-suicidal self-injury with and without suicidal self-injury. J Affect Disord. 2024;347:57–65.

    Article  PubMed  Google Scholar 

  24. Lee PH, Tervoclemmens B, Liu RT, Gersten MB, Jung J, Janes AC, et al. Use of tobacco products and suicide attempts among elementary school-aged children. JAMA Netw Open. 2024;7:e240376.

    Article  PubMed  PubMed Central  Google Scholar 

  25. Xie X, Li Y, Liu J, Zhang L, Sun T, Zhang C, et al. The relationship between childhood maltreatment and non-suicidal self-injury in adolescents with depressive disorders. Psychiatry Res. 2024;331:115638.

    Article  CAS  PubMed  Google Scholar 

  26. Cwik MF, Barlow A, Tingey L, Larzelere-Hinton F, Goklish N, Walkup JT. Nonsuicidal self-injury in an American Indian reservation community: results from the White Mountain Apache surveillance system, 2007-2008. J Am Acad Child Adolesc Psychiatry. 2011;50:860–9.

    Article  PubMed  Google Scholar 

  27. Qu D, Wen X, Liu B, Zhang X, He Y, Chen D, et al. Non-suicidal self-injury in Chinese population: a scoping review of prevalence, method, risk factors and preventive interventions. Lancet Reg Health West Pac. 2023;37:100794.

    PubMed  PubMed Central  Google Scholar 

  28. Fusar-Poli P, Radua J. Ten simple rules for conducting umbrella reviews. Evid Based Ment Health. 2018;21:95–100.

    Article  PubMed  PubMed Central  Google Scholar 

  29. Page MJ, McKenzie JE, Bossuyt PM, Boutron I, Hoffmann TC, Mulrow CD, et al. The PRISMA 2020 statement: an updated guideline for reporting systematic reviews. BMJ. 2021;372:n71.

    Article  PubMed  PubMed Central  Google Scholar 

  30. Hailes HP, Yu R, Danese A, Fazel S. Long-term outcomes of childhood sexual abuse: an umbrella review. Lancet Psychiatry. 2019;6:830–9.

    Article  PubMed  PubMed Central  Google Scholar 

  31. American Psychiatric Association(APA). Diagnostic and statistical manual of mental disorders Fifth Edition(DSM-5) Arlington American Psychiatric Association; 2013.

  32. Radua J, Ramella-Cravaro V, Ioannidis JPA, Reichenberg A, Phiphopthatsanee N, Amir T, et al. What causes psychosis? an umbrella review of risk and protective factors. World Psychiatry. 2018;17:49–66.

    Article  PubMed  PubMed Central  Google Scholar 

  33. Lane MM, Gamage E, Du S, Ashtree DN, McGuinness AJ, Gauci S, et al. Ultra-processed food exposure and adverse health outcomes: umbrella review of epidemiological meta-analyses. BMJ. 2024;384:e077310.

    Article  PubMed  PubMed Central  Google Scholar 

  34. Veronese N, Demurtas J, Thompson T, Solmi M, Pesolillo G, Celotto S, et al. Effect of low-dose aspirin on health outcomes: an umbrella review of systematic reviews and meta-analyses. Br J Clin Pharmacol. 2020;86:1465–75.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  35. Favril L, Yu R, Geddes JR, Fazel S. Individual-level risk factors for suicide mortality in the general population: an umbrella review. Lancet Public Health. 2023;8:e868–e877.

    Article  PubMed  PubMed Central  Google Scholar 

  36. Radua J, De Prisco M, Oliva V, Fico G, Vieta E, Fusar‐Poli P. Impact of air pollution and climate change on mental health outcomes: an umbrella review of global evidence. World Psychiatry. 2024;23:244–56.

    Article  PubMed  PubMed Central  Google Scholar 

  37. Cochrane Handbook for Systematic Reviews of Interventions. https://training.cochrane.org/handbook/current. Accessed 24 May 2024.

  38. IntHout J, Ioannidis JPA, Rovers MM, Goeman JJ. Plea for routinely presenting prediction intervals in meta-analysis. BMJ Open. 2016;6:e010247.

    Article  PubMed  PubMed Central  Google Scholar 

  39. Higgins JPT, Thompson SG, Spiegelhalter DJ. A re-evaluation of random-effects meta-analysis. J R Stat Soc Ser A Stat Soc. 2009;172:137–59.

    Article  PubMed  PubMed Central  Google Scholar 

  40. Egger M, Davey Smith G, Schneider M, Minder C. Bias in meta-analysis detected by a simple, graphical test. BMJ. 1997;315:629–34.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  41. Sterne JA, Egger M. Funnel plots for detecting bias in meta-analysis: guidelines on choice of axis. J Clin Epidemiol. 2001;54:1046–55.

    Article  CAS  PubMed  Google Scholar 

  42. Shea BJ, Reeves BC, Wells G, Thuku M, Hamel C, Moran J, et al. AMSTAR 2: a critical appraisal tool for systematic reviews that include randomised or non-randomised studies of healthcare interventions, or both. BMJ. 2017;358:j4008.

    Article  PubMed  PubMed Central  Google Scholar 

  43. Xu T, Zhang T, Zhang F, Zhou X. Influencing factors of self-injury behaviors among Chinese adolescents: a meta-analysis. Mod Preventive Med. 2021;48:706–709713.

    Google Scholar 

  44. Tao M, Feng L, Guo F, Hai F, Yang S. Meta-analysis on the detection rate and influencing factors of non-suicide self-injury among adolescents in China. J Guangxi Med Univ. 2023;40:1627–34.

    Google Scholar 

  45. Xu D, Feng Q, Xu H. Meta-analysis of risk factors for non-suicidal self-injury among Chinese adolescents. Psychol Monthly. 2023;18:21–25.

    Google Scholar 

  46. Wen S, Guo Z, Wang T, Ou X, Xie Z, Yang Q, et al. Screen time and health risks among children and adolescents in China: a meta-analysis. China Preventive Med. 2023;24:662–7.

    Google Scholar 

  47. Witt K, Milner A, Spittal MJ, Hetrick S, Robinson J, Pirkis J, et al. Population attributable risk of factors associated with the repetition of self-harm behaviour in young people presenting to clinical services: a systematic review and meta-analysis. Eur Child Adoles Psy. 2019;28:5–18.

    Article  Google Scholar 

  48. Wang Y, Li X, Ng CH, Xu D-W, Hu S, Yuan T. Risk factors for non-suicidal self-injury (NSSI) in adolescents: a meta-analysis. EClinicalMedicine. 2022;46:101350.

    Article  PubMed  PubMed Central  Google Scholar 

  49. Nesi J, Burke TA, Bettis AH, Kudinova AY, Thompson EC, MacPherson HA, et al. Social media use and self-injurious thoughts and behaviors: a systematic review and meta-analysis. Clin Psychol Rev. 2021;87:102038.

    Article  PubMed  PubMed Central  Google Scholar 

  50. Marchi M, Arcolin E, Fiore G, Travascio A, Uberti D, Amaddeo F, et al. Self-harm and suicidality among LGBTIQ people: a systematic review and meta-analysis. Int Rev Psychiatry. 2022;34:240–56.

    Article  PubMed  Google Scholar 

  51. Lin K, Ramos S, Sun J. Urbanization, self-harm, and suicidal ideation in left-behind children and adolescents in China: a systematic review and meta-analysis. Curr Opin Psychiatry. 2024;37:225–36.

    Article  PubMed  Google Scholar 

  52. Huang H, Ding Y, Wan X, Liang Y, Zhang Y, Lu G, et al. A meta-analysis of the relationship between bullying and non-suicidal self-injury among children and adolescents. Sci Rep. 2022;12:17285.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  53. Heerde JA, Hemphill SA. Are bullying perpetration and victimization associated with adolescent deliberate self-harm? a meta-analysis. Arch Suicide Res. 2019;23:353–81.

    Article  PubMed  Google Scholar 

  54. Fox KR, Franklin JC, Ribeiro JD, Kleiman EM, Bentley KH, Nock MK. Meta-analysis of risk factors for nonsuicidal self-injury. Clin Psychol Rev. 2015;42:156–67.

    Article  PubMed  PubMed Central  Google Scholar 

  55. Epstein S, Roberts E, Sedgwick R, Polling C, Finning K, Ford T, et al. School absenteeism as a risk factor for self-harm and suicidal ideation in children and adolescents: a systematic review and meta-analysis. Eur Child Adoles Psy. 2020;29:1175–94.

    Article  Google Scholar 

  56. Calvo N, Lugomarín J, Oriol M, Pérezgalbarro C, Restoy D, Ramosquiroga J, et al. Childhood maltreatment and non-suicidal self-injury in adolescent population: a systematic review and meta-analysis. Child Abuse Negl. 2024;157:107048.

    Article  PubMed  Google Scholar 

  57. Haney AM. Nonsuicidal self-injury and religiosity: a meta-analytic investigation. Am J Orthopsychiatry. 2020;90:78–89.

    Article  PubMed  Google Scholar 

  58. Thornicroft G, Sunkel C, Milenova M. Commission implementation partnership. how to stop stigma: implementing the lancet commission on ending stigma and discrimination in mental health. Lancet Psychiatry. 2024;11:88–89.

    Article  PubMed  Google Scholar 

  59. Freeman M, Mulutsi NE. Law and policy are essential but insufficient to end stigma and discrimination in mental health. Lancet. 2022;400:1387–9.

    Article  PubMed  Google Scholar 

  60. Thornicroft G, Sunkel C, Alikhon Aliev A, Baker S, Brohan E, El Chammay R, et al. The Lancet Commission on ending stigma and discrimination in mental health. Lancet. 2022;400:1438–80.

    Article  PubMed  Google Scholar 

  61. Dvir M, Sarah A, Orna B. Ethnic identity and barriers for using mental health services among Arab-Bedouin women coping with emotional distresses. Arch Womens Ment Health. 2023;26:609–24.

    Article  PubMed  Google Scholar 

  62. UIS Statistics. https://data.uis.unesco.org/. Accessed 11 July 2024.

  63. The price of inaction: the global private, fiscal and social costs of children and youth not learning | UNESCO. https://www.unesco.org/en/articles/price-inaction-global-private-fiscal-and-social-costs-children-and-youth-not-learning. Accessed 11 July 2024.

  64. Geulayov G, Casey D, McDonald KC, Foster P, Pritchard K, Wells C, et al. Incidence of suicide, hospital-presenting non-fatal self-harm, and community-occurring non-fatal self-harm in adolescents in England (the iceberg model of self-harm): a retrospective study. Lancet Psychiatry. 2018;5:167–74.

    Article  PubMed  Google Scholar 

  65. McManus S, Gunnell D, Cooper C, Bebbington PE, Howard LM, Brugha T, et al. Prevalence of non-suicidal self-harm and service contact in England, 2000-14: repeated cross-sectional surveys of the general population. Lancet Psychiatry. 2019;6:573–81.

    Article  PubMed  PubMed Central  Google Scholar 

  66. John A, Friedmann Y, DelPozo-Banos M, Frizzati A, Ford T, Thapar A. Association of school absence and exclusion with recorded neurodevelopmental disorders, mental disorders, or self-harm: a nationwide, retrospective, electronic cohort study of children and young people in Wales, UK. Lancet Psychiatry. 2022;9:23–34.

    Article  PubMed  Google Scholar 

  67. Bonell C, Blakemore S-J, Fletcher A, Patton G. Role theory of schools and adolescent health. Lancet Child Adolesc Health. 2019;3:742–8.

    Article  PubMed  Google Scholar 

  68. Shinde S, Weiss HA, Varghese B, Khandeparkar P, Pereira B, Sharma A, et al. Promoting school climate and health outcomes with the SEHER multi-component secondary school intervention in Bihar, India: a cluster-randomised controlled trial. Lancet. 2018;392:2465–77.

    Article  PubMed  Google Scholar 

  69. Ougrin D, Asarnow JR. The end of family therapy for self-harm, or a new beginning? Lancet Psychiatry. 2018;5:188–9.

    Article  PubMed  Google Scholar 

  70. Compulsory Education Law of the People’s Republic of China. http://www.moe.gov.cn/jyb_sjzl/sjzl_zcfg/zcfg_jyfl/202110/t20211029_575949.html. Accessed 11 June 2024.

  71. Ministry of Education of the People’s Republic of China. MOE discusses key tasks for education supervision in 2024. 2024. http://en.moe.gov.cn/news/press_releases/202405/t20240508_1129403.html. Accessed 11 June 2024.

  72. Kearney CA, Graczyk P. A response to intervention model to promote school attendance and decrease school absenteeism. Child Youth Care For. 2014;43:1–25.

    Google Scholar 

  73. Van Ginneken N, Chin WY, Lim YC, Ussif A, Singh R, Shahmalak U, et al. Primary-level worker interventions for the care of people living with mental disorders and distress in low- and middle-income countries. Cochrane Db Syst Rev. 2021;8:CD009149.

    Google Scholar 

  74. MacDonald S, Sampson C, Turley R, Biddle L, Ring N, Begley R, et al. Patients’ experiences of emergency hospital care following self-harm: systematic review and thematic synthesis of qualitative research. Qual Health Res. 2020;30:471–85.

    Article  PubMed  Google Scholar 

  75. Why Does Bullying Happen? Better Help. 2024. https://www.betterhelp.com. Accessed 18 July 2024.

  76. Shinde S, Weiss HA, Khandeparkar P, Pereira B, Sharma A, Gupta R, et al. A multicomponent secondary school health promotion intervention and adolescent health: an extension of the SEHER cluster randomised controlled trial in Bihar, India. PLoS Med. 2020;17:e1003021.

    Article  PubMed  PubMed Central  Google Scholar 

  77. Mok PLH, Antonsen S, Pedersen CB, Carr MJ, Kapur N, Nazroo J, et al. Family income inequalities and trajectories through childhood and self-harm and violence in young adults: a population-based, nested case-control study. Lancet Public Health. 2018;3:e498–e507.

    Article  PubMed  Google Scholar 

  78. Chen M, Zhou Y, Luo D, Yan S, Liu M, Wang M, et al. Association of family function and suicide risk in teenagers with a history of self-harm behaviors: mediating role of subjective wellbeing and depression. Front Public Health. 2023;11:1164999.

    Article  PubMed  PubMed Central  Google Scholar 

  79. McConkey R, O’Hagan P, Corcoran J. The impact of a family-centred intervention for parents of children with developmental disabilities: a model project in rural Ireland. Children. 2023;10:175.

    Article  PubMed  PubMed Central  Google Scholar 

  80. Cottrell DJ, Wright-Hughes A, Collinson M, Boston P, Eisler I, Fortune S, et al. Effectiveness of systemic family therapy versus treatment as usual for young people after self-harm: a pragmatic, phase 3, multicentre, randomised controlled trial. Lancet Psychiatry. 2018;5:203–16.

    Article  PubMed  PubMed Central  Google Scholar 

  81. Florindo Salvador V, Gouveia-Pereira M, Simões B, Duarte E. Young adults who self-harm: Barriers to and facilitators of seeking help. Psychiatry Res. 2023;327:115390.

    Article  PubMed  Google Scholar 

  82. Strobel NA, Chamberlain C, Campbell SK, Shields L, Bainbridge RG, Adams C, et al. Family-centred interventions for Indigenous early childhood well-being by primary healthcare services. Cochrane Database Syst Rev. 2022;12:CD012463.

    PubMed  PubMed Central  Google Scholar 

  83. Lonergan A, Moriarty A, McNicholas F, Byrne T. Cyberbullying and internet safety: a survey of child and adolescent mental health practitioners. Ir J Psychol Med. 2023;40:43–50.

    Article  PubMed  Google Scholar 

  84. Gini G, Espelage DL. Peer victimization, cyberbullying, and suicide risk in children and adolescents. JAMA. 2014;312:545–6.

    Article  PubMed  Google Scholar 

  85. Kruzan KP, Whitlock J, Chapman J, Bhandari A, Bazarova N. Young adults’ perceptions of 2 publicly available digital resources for self-injury: qualitative study of a peer support app and web-based factsheets. JMIR Form Res. 2023;7:e41546.

    Article  PubMed  PubMed Central  Google Scholar 

  86. Mann JJ, Michel CA, Auerbach RP. Improving suicide prevention through evidence-based strategies: a systematic review. Am J Psychiatry. 2021;178:611–24.

    Article  PubMed  PubMed Central  Google Scholar 

  87. Meng S, Dong P, Sun Y, Li Y, Chang X, Sun G, et al. Guidelines for prevention and treatment of internet addiction in adolescents during home quarantine for the COVID-19 pandemic. Heart Mind. 2020;4:95.

    Article  Google Scholar 

  88. Ozbay FA, Alatas B. Fake news detection within online social media using supervised artificial intelligence algorithms. Phys A: Stat Mech Its Appl. 2020;540:123174.

    Article  Google Scholar 

  89. Dewani A, Memon MA, Bhatti S. Cyberbullying detection: advanced preprocessing techniques & deep learning architecture for Roman Urdu data. J Big Data. 2021;8:160.

    Article  PubMed  PubMed Central  Google Scholar 

  90. Yadav J, Kumar D, Chauhan D Cyberbullying detection using pre-trained BERT model. 2020 International Conference on Electronics and Sustainable Communication Systems (ICESC), 2020. p. 1096–1100.

  91. Perera A, Fernando P. Accurate cyberbullying detection and prevention on social Media. Procedia Comput Sci. 2021;181:605–11.

    Article  Google Scholar 

  92. Wang D, Zhang M, Mujumdar AS, Yu D. Advanced detection techniques using artificial intelligence in processing of berries. Food Eng Rev. 2022;14:176–99.

    Article  Google Scholar 

  93. Vos T, Lim SS, Abbafati C, Abbas KM, Abbasi M, Abbasifard M, et al. Global burden of 369 diseases and injuries in 204 countries and territories, 1990–2019: a systematic analysis for the Global Burden of Disease Study 2019. Lancet. 2020;396:1204–22.

    Article  Google Scholar 

  94. Self-harm and Suicide Prevention Competence Framework. https://www.ucl.ac.uk/pals/research/clinical-educational-and-health-psychology/research-groups/core/competence-frameworks/self. Accessed 5 June 2024.

  95. Sun Y, Bao Y, Ravindran A, Sun Y, Shi J, Lu L. Mental health challenges raised by rapid socioeconomic transformations in China: lessons learned and prevention strategies. Heart Mind. 2020;4:59.

    Article  Google Scholar 

  96. Richardson R, Connell T, Foster M, Blamires J, Keshoor S, Moir C, et al. Risk and protective factors of self-harm and suicidality in adolescents: an umbrella review with meta-analysis. J Youth Adolescence. 2024;53:1301–22.

    Article  Google Scholar 

Download references

Acknowledgements

We wish to thank Prof. Paul Moran, Prof. Ian B Hickie and Prof. Arun Ravindran, who generously shared their experience and perspectives with us.

Funding

This work was supported in part by the Brain Science and Brain-like Intelligence Technology-National Science and Technology Major Project (2021ZD0200800, 2021ZD0200700), National Key Research and Development Project of China (2024YFC2707804), and National Natural Science Foundation of China (no. 82288101, 82301681, 82171514).

Author information

Author notes

  1. These authors contributed equally: Yi Zhong, Zi-Wei Zhang, Jia-Hao Ding, Yan-Kun Sun.

Authors and Affiliations

  1. Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Center for Mental disorders, National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Peking University, Beijing, China

    Yi Zhong, Yan-Kun Sun, Yi-Fan Yu, Si-Zhen Su, Yi-Miao Gong, Wei-Feng Mi, Wei Yan, Kai Yuan, Le Shi, Xiao-Xing Liu & Lin Lu

  2. National Institute on Drug Dependence and Beijing Key Laboratory of Drug Dependence, Peking University, Beijing, China

    Zi-Wei Zhang, Yan-Ping Bao & Lin Lu

  3. School of Public Health, Peking University, Beijing, China

    Zi-Wei Zhang & Yan-Ping Bao

  4. Institute of Brain Science and Brain-inspired Research, Shandong First Medical University and Shandong Academy of Medical Sciences, Jinan, Shandong, China

    Jia-Hao Ding, Yong-Bo Zheng, Zhe Wang & Lin Lu

  5. Department of Psychology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, China

    Yong-Bo Zheng, Yu-Mei Wang & Zhe Wang

  6. Research Unit of Diagnosis and Treatment of Mood Cognitive Disorder, Chinese Academy of Medical Sciences (No.2018RU006), Institute of Basic Medical Sciences, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China

    Zi-Chun Guan & Ting-Ting Wu

  7. Pain Medicine Center, Peking University Third Hospital, Peking University, Beijing, China

    Jie Sun

  8. Pakistan Psychiatric Research Centre, Fountain House, Lahore, Pakistan

    Afzal Javed

  9. National Centre for Suicide Research and Prevention of Mental Ill-Health (NASP), Department of Learning, Informatics, Management and Ethics, Karolinska Institutet, Stockholm, Sweden

    Danuta Wasserman

  10. Peking-Tsinghua Centre for Life Sciences and PKU-IDG/McGovern Institute for Brain Research, Peking University, Beijing, China

    Lin Lu

Authors
  1. Yi Zhong
    View author publications

    Search author on:PubMed Google Scholar

  2. Zi-Wei Zhang
    View author publications

    Search author on:PubMed Google Scholar

  3. Jia-Hao Ding
    View author publications

    Search author on:PubMed Google Scholar

  4. Yan-Kun Sun
    View author publications

    Search author on:PubMed Google Scholar

  5. Yong-Bo Zheng
    View author publications

    Search author on:PubMed Google Scholar

  6. Yi-Fan Yu
    View author publications

    Search author on:PubMed Google Scholar

  7. Zi-Chun Guan
    View author publications

    Search author on:PubMed Google Scholar

  8. Si-Zhen Su
    View author publications

    Search author on:PubMed Google Scholar

  9. Ting-Ting Wu
    View author publications

    Search author on:PubMed Google Scholar

  10. Yi-Miao Gong
    View author publications

    Search author on:PubMed Google Scholar

  11. Wei-Feng Mi
    View author publications

    Search author on:PubMed Google Scholar

  12. Wei Yan
    View author publications

    Search author on:PubMed Google Scholar

  13. Jie Sun
    View author publications

    Search author on:PubMed Google Scholar

  14. Yu-Mei Wang
    View author publications

    Search author on:PubMed Google Scholar

  15. Kai Yuan
    View author publications

    Search author on:PubMed Google Scholar

  16. Le Shi
    View author publications

    Search author on:PubMed Google Scholar

  17. Zhe Wang
    View author publications

    Search author on:PubMed Google Scholar

  18. Afzal Javed
    View author publications

    Search author on:PubMed Google Scholar

  19. Xiao-Xing Liu
    View author publications

    Search author on:PubMed Google Scholar

  20. Yan-Ping Bao
    View author publications

    Search author on:PubMed Google Scholar

  21. Danuta Wasserman
    View author publications

    Search author on:PubMed Google Scholar

  22. Lin Lu
    View author publications

    Search author on:PubMed Google Scholar

Contributions

L Lu, YP Bao, XX Liu, and Y Zhong proposed the topic of the meta-analysis. Y Zhong, ZW Zhang, JH Ding, YB Zheng, YF Yu and ZC Guan performed the literature search, data curation, and data visualization. Y Zhong, ZW Zhang, and JH Ding wrote the original manuscript, and XX Liu, YP Bao, D Wasserman and L Lu checked the data and critically revised the manuscript. YB Zheng, SZ Su, W Yan, J Sun, YF Yu, ZC Guan, YM Gong, Z Wang, WF Mi, YM Wang, L Shi, YK Sun, A Javed, and D Wasserman commented on and revised the manuscript. All authors were involved in reviewing and editing the manuscript.

Corresponding authors

Correspondence to Xiao-Xing Liu, Yan-Ping Bao, Danuta Wasserman or Lin Lu.

Ethics declarations

Competing interest

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Additional information

Publisher’s note Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Supplementary information

Rights and permissions

Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Zhong, Y., Zhang, ZW., Ding, JH. et al. What are the correlates of non-suicidal self-injury in children and adolescents? An umbrella systematic review of global evidence. Mol Psychiatry (2026). https://doi.org/10.1038/s41380-026-03605-4

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Version of record:

  • DOI: https://doi.org/10.1038/s41380-026-03605-4

Search

Advanced search

Quick links