Top

BMC Psychiatry

Published in:

01-12-2020 | Suicide | Research article

Self-harm with suicidal and non-suicidal intent in young people in sub-Saharan Africa: a systematic review

Authors: Emmanuel N-B Quarshie, Mitch G. Waterman, Allan O. House

Published in: BMC Psychiatry | Issue 1/2020

Abstract

Background

Self-harm, whether attributed to suicidal or non-suicidal motives, is associated with several poor outcomes in young people, including eventual suicide. Much of our understanding of self-harm in young people is based on literature from Europe (particularly, the UK), North America, and Australia. We aimed to synthesise the available evidence on prevalence, the commonly reported self-harm methods, correlates, risk and protective factors, and reasons for self-harm, in adolescents (aged 10–25 years) in sub-Saharan Africa.

Method

We searched MEDLINE, PsycINFO, PubMed, African Journals OnLine, and African Index Medicus for records from 1950 through August 2019, without language restrictions. We supplemented the database searches by searching relevant portals for postgraduate theses, reference harvesting, contacting authors for unpublished studies, and hand searching relevant print sources. We applied narrative synthesis to the evidence.

Results

Seventy-four studies from 18 sub-Saharan African countries met the inclusion criteria. The median lifetime prevalence estimate was 10·3% (interquartile range [IQR] 4·6% – 16·1%); median 12-month prevalence estimate was 16·9% (IQR: 11·5% – 25·5%); median 6-month prevalence estimate was 18·2% (IQR: 12·7% – 21·8%); and the median 1-month prevalence estimate was 3·2% (IQR: 2·5–14·8%). Studies from Western sub-Saharan Africa reported the highest 12-month prevalence estimates (median = 24·3%; IQR = 16·9% – 27·9%). Clinical samples commonly reported overdose, whereas self-cutting was most commonly reported in non-clinical samples. Academic failure, sexual, emotional, and physical abuse, romantic relationship problems, family conflict, depression, and previous self-harm were identified as key correlates of self-harm. No study reported protective factors against self-harm.

Conclusion

Variation in estimates was explained by small sample sizes and variation in definitions and measures used. Exploration of associations, risks and protective factors was based upon concepts and measures derived from high income countries. More detailed and culturally sensitive research is needed to understand the context-specific risks and protective factors for self-harm in adolescents in sub-Saharan Africa.

Available only for authorised users

Platt S, Bille-Brahe U, Kerkhof A, Schmidtke A, Bjerke T, Crepet P, De Leo D, Haring C, Lonnqvist J, Michel K, et al. Parasuicide in Europe: The WHO/EURO multicentre study on parasuicide: I. Introduction and preliminary analysis for 1989. Acta Psychiatrica Scandinavica. 1992;85(2):97–104. https://doi.org/10.1111/j.1600-0447.1992.tb01451.x..CrossRefPubMed

World Health Organization. Practice manual for establishing and maintaining surveillance systems for suicide attempts and self-harm. Geneva: WHO; 2016.

Grandclerc S, De Labrouhe D, Spodenkiewicz M, Lachal J, Moro M-R. Relations between nonsuicidal self-injury and suicidal behavior in adolescence: a systematic review. PLoS One. 2016;11(4):e0153760. https://doi.org/10.1371/journal.pone.0153760.CrossRefPubMedPubMedCentral

Mars B, Heron J, Klonsky ED, Moran P, O'Connor RC, Tilling K, Wilkinson P, Gunnell D. Predictors of future suicide attempt among adolescents with suicidal thoughts or non-suicidal self-harm: a population-based birth cohort study. Lancet Psychiatry. 2019;6(4):327–37. https://doi.org/10.1016/S2215-0366(19)30030-6.CrossRefPubMedPubMedCentral

Madge N, Hewitt A, Hawton K, Wilde EJ, Corcoran P, Fekete S, Heeringen KV, Leo DD, Ystgaard M. Deliberate self-harm within an international community sample of young people: comparative findings from the Child & Adolescent Self-harm in Europe (CASE) study. J Child Psychol Psychiatry. 2008;49(6):667–77. https://doi.org/10.1111/j.1469-7610.2008.01879.x.CrossRefPubMed

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(1):10. https://doi.org/10.1186/1753-2000-6-10.CrossRefPubMedPubMedCentral

Swannell SV, Martin GE, Page A, Hasking P, St John NJ. Prevalence of nonsuicidal self-injury in nonclinical samples: systematic review, meta-analysis and meta-regression. Suicide Life Threat Behav. 2014;44(3):273–303. https://doi.org/10.1111/sltb.12070.CrossRefPubMed

Valencia-Agudo F, Burcher GC, Ezpeleta L, Kramer T. Nonsuicidal self-injury in community adolescents: a systematic review of prospective predictors, mediators and moderators. J Adolesc. 2018;65:25–38. https://doi.org/10.1016/j.adolescence.2018.02.012.CrossRefPubMed

Mortier P, Cuijpers P, Kiekens G, Auerbach R, Demyttenaere K, Green J, Kessler R, Nock M, Bruffaerts R. The prevalence of suicidal thoughts and behaviours among college students: a meta-analysis. Psychol Med. 2018;48(4):554–65. https://doi.org/10.1017/S0033291717002215.CrossRefPubMed

10.

Aggarwal S, Patton G, Reavley N, Sreenivasan SA, Berk M. Youth self-harm in low-and middle-income countries: systematic review of the risk and protective factors. Int J Soc Psychiatry. 2017;63(4):359–75. https://doi.org/10.1177/0020764017700175.CrossRefPubMed

11.

Canetto SS. Suicidal behaviors among Muslim women. Patterns, pathways, meanings, and prevention. Crisis. 2015;36(6):447–58. https://doi.org/10.1027/0227-5910/a000347.CrossRefPubMed

12.

Mars B, Burrows S, Hjelmeland H, Gunnell D. Suicidal behaviour across the African continent: a review of the literature. BMC Public Health. 2014;14(1):606. https://doi.org/10.1186/1471-2458-14-606.CrossRefPubMedPubMedCentral

13.

Liberati A, Altman DG, Tetzlaff J, Mulrow C, Gøtzsche PC, Ioannidis JP, Clarke M, Devereaux PJ, Kleijnen J, Moher D. The PRISMA statement for reporting systematic reviews and meta-analyses of studies that evaluate health care interventions: explanation and elaboration. PLoS Med. 2009;6(7):e1000100. https://doi.org/10.1371/journal.pmed.1000100.CrossRefPubMedPubMedCentral

14.

Pienaar E, Grobler L, Busgeeth K, Eisinga A, Siegfried N. Developing a geographic search filter to identify randomised controlled trials in Africa: finding the optimal balance between sensitivity and precision. Health Inform Libraries J. 2011;28(3):210–5. https://doi.org/10.1111/j.1471-1842.2011.00936.x.CrossRef

15.

Davis RHJ. Independent Africa (1960 to present). In: Encyclopedia of African history and culture. Vol. V. New York: Facts on File; 2005.

16.

Haddaway NR, Collins AM, Coughlin D, Kirk S. The role of Google scholar in evidence reviews and its applicability to grey literature searching. PLoS One. 2015;10(9):e0138237. https://doi.org/10.1371/journal.pone.0138237.CrossRefPubMedPubMedCentral

17.

Hong QN, Pluye P, Fàbregues S, Bartlett G, Boardman F, Cargo M, Dagenais P, Gagnon M-P, Griffiths F, Nicolau B. VP26 A critical appraisal tool for systematic mixed studies reviews. Int J Technol Assessment Health Care. 2018;34(S1):166. https://doi.org/10.1017/s0266462318003471.CrossRef

18.

Ioannidis JP, Patsopoulos NA, Rothstein HR. Reasons or excuses for avoiding meta-analysis in forest plots. BMJ. 2008;336(7658):1413–5. https://doi.org/10.2307/20510099.CrossRefPubMedPubMedCentral

19.

Petticrew M, Roberts H. Systematic reviews in the social sciences: a practical guide. Oxford: John Wiley & Sons; 2006.CrossRef

20.

Omigbodun O, Dogra N, Esan O, Adedokun B. Prevalence and correlates of suicidal behaviour among adolescents in Southwest Nigeria. Int J Soc Psychiatry. 2008;54(1):34–46. https://doi.org/10.1177/0020764007078360.CrossRefPubMed

21.

Kapur N, Cooper J, O'Connor RC, Hawton K. Non-suicidal self-injury v. attempted suicide: new diagnosis or false dichotomy? Br J Psychiatry. 2013;202(5):326–8. https://doi.org/10.1192/bjp.bp.112.116111.CrossRefPubMed

22.

Sefa-Dedeh A, Canetto, SS.: Women, Family and suicidal behaviour in Ghana. In: Psychology in international perspective: 50 years of the international council of psychologists. Edited by Gielen UP, Adler, LL., Milgram, NA. Amsterdam/Lisse: Swets & Zeitlinger B.V.; 1992: 299–309.

23.

Wassenaar DR, van der Veen MB, Pillay AL. Women in cultural transition: suicidal behavior in south African Indian women. Suicide Life Threat Behav. 1998;28(1):82–93. https://doi.org/10.1111/j.1943-278X.1998.tb00628.x.CrossRefPubMed

24.

Beekrum R, Valjee SR, Collings SJ. An emic perspective on the dynamics of non-fatal suicidal behaviour in a sample of south African Indian women. S Afr J Psychol. 2011;41(1):63–73. https://doi.org/10.1177/008124631104100107.CrossRef

25.

Gage AJ. Association of child marriage with suicidal thoughts and attempts among adolescent girls in Ethiopia. J Adolesc Health. 2013;52(5):654–6. https://doi.org/10.1016/j.jadohealth.2012.12.007.CrossRefPubMed

26.

Kritzinger AM. Investigations into adolescent non-fatal suicidal behaviour at a Gauteng public hospital: patient and staff experiences. Doctoral thesis. Pretoria: University of Pretoria; 2018.

27.

Meissner BL, Bantjes J. Disconnection, reconnection and autonomy: four young south African men’s experience of attempting suicide. J Youth Stud. 2017;20(7):781–97. https://doi.org/10.1080/13676261.2016.1273512.CrossRef

28.

Kinyanda E, Kizza R, Levin J, Ndyanabangi S, Abbo C. Adolescent suicidality as seen in rural northeastern Uganda. Crisis. 2011;32(1):43–51. https://doi.org/10.1027/0227-5910/a000059.CrossRefPubMed

29.

Pretorius S. Deliberate self-harm among adolescents in south African children’s homes Master Thesis. South Africa: University of Pretoria; 2011.

30.

Swahn MH, Palmier JB, Kasirye R, Yao H. Correlates of suicide ideation and attempt among youth living in the slums of Kampala. Int J Environ Res Public Health. 2012;9(2):596–609. https://doi.org/10.3390/ijerph9020596.CrossRefPubMedPubMedCentral

31.

Asante KO, Meyer-Weitz A. Prevalence and predictors of suicidal ideations and attempts among homeless children and adolescents in Ghana. J Child Adolesc Ment Health. 2017;29(1):27–37. https://doi.org/10.2989/17280583.2017.1287708.CrossRef

32.

Shilubane HN, Ruiter RA, Bos AE, van den Borne B, James S, Reddy PS. Psychosocial determinants of suicide attempts among black south African adolescents: a qualitative analysis. J Youth Stud. 2012;15(2):177–89. https://doi.org/10.1080/13676261.2011.634400.CrossRef

33.

Cheng Y, Li X, Lou C, Sonenstein FL, Kalamar A, Jejeebhoy S, Delany-Moretlwe S, Brahmbhatt H, Olumide AO, Ojengbede O. The association between social support and mental health among vulnerable adolescents in five cities: findings from the study of the well-being of adolescents in vulnerable environments. J Adolesc Health. 2014;55(6):S31–8. https://doi.org/10.1016/j.jadohealth.2014.08.020.CrossRefPubMed

34.

Flisher A, Ziervogel C, Chalton D, Leger P, Robertson B. Risk-taking behaviour of cape peninsula high-school students. Part II. Suicidal behaviour. S Afr Med J. 1993;83(7):474–6.PubMed

35.

Kebede D, Ketsela T. Suicide attempts in Ethiopian adolescents in Addis Abeba high schools. Ethiop Med J. 1993;31(2):83–90.PubMed

36.

Peltzer K, Cherian V, Cherian L. Cross-cultural attitudes towards suicide among south African secondary school pupils. East Afr Med J. 2000;77(3):165–7.PubMed

37.

Madu S, Matla M. The prevalence of suicidal behaviours among secondary school adolescents in the Limpopo Province, South Africa. S Afr J Psychol. 2003;33(2):126–32. https://doi.org/10.1177/008124630303300208.CrossRef

38.

Wild LG, Flisher AJ, Lombard C. Suicidal ideation and attempts in adolescents: associations with depression and six domains of self-esteem. J Adolesc. 2004;27(6):611–24. https://doi.org/10.1016/j.adolescence.2004.03.001.CrossRefPubMed

39.

Sommer M. Suicidal behaviour of high school students: attempts, ideation and risk factors of south African and German adolescents Master' Thesis. South Africa: University of South Africa; 2005.

40.

Flisher AJ, Ward CL, Liang H, Onya H, Mlisa N, Terblanche S, Bhana A, Parry CD, Lombard CJ. Injury-related behaviour among south African high-school students at six sites. S Afr Med J. 2006;96(9):825–30.PubMed

41.

Shiferaw S, Fantahun M, Bekele A. Psychosocial problems among students in preparatory school, in Dessie town, north East Ethiopia. Ethiop J Health Dev. 2006;20(1):47–55.CrossRef

42.

Peltzer K. Social support and suicide risk among secondary school students in Cape Town, South Africa. Psychol Rep. 2008;103(3):653–60. https://doi.org/10.2466/pr0.103.3.653-660.CrossRefPubMed

43.

Mashego TB, Madu S. Suicide-related behaviours among secondary school adolescents in the Welkom and Bethlehem areas of the Free State province (South Africa). S Afr J Psychol. 2009;39(4):489–97. https://doi.org/10.1177/008124630903900410.CrossRef

44.

Nanewortor FS. Impact of religiosity, Africentric values and psychological distress on adolescent suicidal ideation. Master Thesis. Ghana: University of Ghana; 2011.

45.

Campbell CS. Life stressors and resources as predictors of adolescent suicide attempt Master Thesis. South Africa: University of the Free State; 2012.

46.

Van Niekerk L, Scribante L, Raubenheimer P. Suicidal ideation and attempt among south African medical students. South Afr Med J. 2012;102(6):372–3. https://doi.org/10.7196/samj.5503.CrossRef

47.

Vawda NB. Associations between family suicide and personal suicidal behaviour among youth in KwaZulu-Natal, South Africa. South Afr Fam Practc. 2012;54(3):244–9. https://doi.org/10.1080/20786204.2012.10874222.CrossRef

48.

Muula AS, Siziya S, Rudatsikira E. Self-inflicted serious injuries among adolescents in Zambia. Tanzania J Health Res. 2013;15(1):1–8. https://doi.org/10.4314/thrb.v15i1.7.CrossRef

49.

Shilubane HN, Ruiter RA, van den Borne B, Sewpaul R, James S, Reddy PS. Suicide and related health risk behaviours among school learners in South Africa: results from the 2002 and 2008 national youth risk behaviour surveys. BMC Public Health. 2013;13(1):926. https://doi.org/10.1186/1471-2458-13-926.CrossRefPubMedPubMedCentral

50.

van Rooyen C. An exploratory study of deliberate self-harm in a south African student population Master Thesis. South Africa: University of Pretoria; 2013.

51.

Chinawa J, Manyike P, Obu H, Odetunde O, Aniwada E, Ndu I, Chinawa A. Behavioral disorder amongst adolescents attending secondary school in Southeast Nigeria. Behav Neurol. 2014;2014:1–10. https://doi.org/10.1155/2014/705835.CrossRef

52.

Lippi C. An exploratory study of the relationship between deliberate self-harm and symptoms of depression and anxiety among a south African university population. Master Thesis. South Africa: University of Pretoria; 2014.

53.

Penning SL, Collings SJ. Perpetration, revictimization, and self-injury: traumatic reenactments of child sexual abuse in a nonclinical sample of south African adolescents. J Child Sex Abuse. 2014;23(6):708–26. https://doi.org/10.1080/10538712.2014.931319.CrossRef

54.

Randall JR, Doku D, Wilson ML, Peltzer K. Suicidal behaviour and related risk factors among school-aged youth in the Republic of Benin. PLoS One. 2014;9(2):e88233. https://doi.org/10.1371/journal.pone.0088233.CrossRefPubMedPubMedCentral

55.

Shilubane HN, Ruiter RA, Bos AE, van den Borne B, James S, Reddy PS. Psychosocial correlates of suicidal ideation in rural south African adolescents. Child Psychiatry Hum Dev. 2014;45(2):153–62. https://doi.org/10.1007/s10578-013-0387-5.CrossRefPubMed

56.

Cluver L, Orkin M, Boyes ME, Sherr L. Child and adolescent suicide attempts, suicidal behavior, and adverse childhood experiences in South Africa: a prospective study. J Adolesc Health. 2015;57(1):52–9. https://doi.org/10.1016/j.jadohealth.2015.03.001.CrossRefPubMed

57.

Ng LC, Kirk CM, Kanyanganzi F, Fawzi MCS, Sezibera V, Shema E, Bizimana JI, Cyamatare FR, Betancourt TS. Risk and protective factors for suicidal ideation and behaviour in Rwandan children. Br J Psychiatry. 2015;207(3):262–8. https://doi.org/10.1192/bjp.bp.114.154591.CrossRefPubMedPubMedCentral

58.

Giru BW. Prevalence and associated factors of suicidal ideation and attempt among high school adolescent students in Fitche Town, north Shoa, Oromia region, Ethiopia, 2012: Institutional based cross sectional study. J Health Medi Nurs. 2016;23(2016):1–12.

59.

Shaikh MA, Lloyd J, Acquah E, Celedonia KL, Wilson ML. Suicide attempts and behavioral correlates among a nationally representative sample of school-attending adolescents in the republic of Malawi. BMC Public Health. 2016;16(1):843. https://doi.org/10.1186/s12889-016-3509-8.CrossRefPubMedPubMedCentral

60.

van der Walt F. Self-harming behaviour among university students: a south African case study. J Psychol Afr. 2016;26(6):508–12. https://doi.org/10.1080/14330237.2016.1250420.CrossRef

61.

Akanni OO, Koleoso ON, Olashore AA, Adayonfo EO, Osundina AF, Ayilara OO. Gender and other risk factors associated with risky behaviours among Nigerian adolescents. J Adolesc. 2017;57:13–7. https://doi.org/10.1016/j.adolescence.2017.03.002.CrossRefPubMed

62.

Asante KO, Kugbey N, Osafo J, Quarshie EN-B, Sarfo JO. The prevalence and correlates of suicidal behaviours (ideation, plan and attempt) among adolescents in senior high schools in Ghana. SSM-Population Health. 2017;3:427–34. https://doi.org/10.1016/j.ssmph.2017.05.005.CrossRef

63.

James S, Reddy SP, Ellahebokus A, Sewpaul R, Naidoo P. The association between adolescent risk behaviours and feelings of sadness or hopelessness: a cross-sectional survey of south African secondary school learners. Psychol Health Med. 2017;22(7):778–89. https://doi.org/10.1080/13548506.2017.1300669.CrossRefPubMed

64.

Nyandindi US. Tanzania Mainland Global School-based Student Health Survey Country Report; 2017.

65.

Peltzer K, Pengpid S. Lifestyle and mental health among school-going adolescents in Namibia. J Psychol Afr. 2017;27(1):69–73. https://doi.org/10.1080/14330237.2016.1268293.CrossRef

66.

Stansfeld SA, Rothon C, Das-Munshi J, Mathews C, Adams A, Clark C, Lund C. Exposure to violence and mental health of adolescents: south African health and well-being study. BJPsych Open. 2017;3(5):257–64. https://doi.org/10.1192/bjpo.bp.117.004861.CrossRefPubMedPubMedCentral

67.

Amare T, Meseret Woldeyhannes S, Haile K, Yeneabat T. Prevalence and associated factors of suicide ideation and attempt among adolescent high school students in Dangila town, Northwest Ethiopia. Psychiatry J. 2018;2018. https://doi.org/10.1155/2018/7631453.

68.

Khuzwayo N, Taylor M, Connolly C. High risk of suicide among high-school learners in uMgungundlovu district, KwaZulu-Natal Province, South Africa. South Afr Med J. 2018;108(6):517–23. https://doi.org/10.7196/samj.2018.v108i6.12843.CrossRef

69.

Liu X, Huang Y, Liu Y. Prevalence, distribution, and associated factors of suicide attempts in young adolescents: school-based data from 40 low-income and middle-income countries. PLoS One. 2018;13(12):e0207823. https://doi.org/10.1371/journal.pone.0207823.CrossRefPubMedPubMedCentral

70.

van der Wal W, George AA. Social support-oriented coping and resilience for self-harm protection among adolescents. J Psychol Afr. 2018;28(3):237–41. https://doi.org/10.1080/14330237.2018.1475508.CrossRef

71.

Baiden P, Kuuire VZ, Shrestha N, Tonui BC, Dako-Gyeke M, Peters KK. Bullying victimization as a predictor of suicidal ideation and suicide attempt among senior high school students in Ghana: results from the 2012 Ghana global school-based health survey. J Sch Violence. 2019;18(2):300–17. https://doi.org/10.1080/15388220.2018.1486200.CrossRef

72.

Brittain K, Myer L, Phillips N, Cluver LD, Zar HJ, Stein DJ, Hoare J. Behavioural health risks during early adolescence among perinatally HIV-infected south African adolescents and same-age, HIV-uninfected peers. Aids Care. 2019;31(1):131–40. https://doi.org/10.1080/09540121.2018.1533233.CrossRefPubMed

73.

Darré T, Consuela KAC, Saka B, Djiwa T, Ekouévi KD, Napo-Koura G. Suicidal ideation and suicide attempts in subjects aged 15–19 in Lomé (Togo). BMC Res Notes. 2019;12(1):187. https://doi.org/10.1186/s13104-019-4233-0.CrossRefPubMedPubMedCentral

74.

Koyanagi A, Oh H, Carvalho AF, Smith L, Haro JM, Vancampfort D, Stubbs B, Devylder JE. Bullying victimization and suicide attempt among adolescents aged 12–15 years from 48 countries. J Am Acad Child Adolesc Psychiatry. 2019;58(9):907–18. https://doi.org/10.1016/j.jaac.2018.10.018.CrossRefPubMed

75.

Koyanagi A, Stubbs B, Oh H, Veronese N, Smith L, Haro JM, Vancampfort D. Food insecurity (hunger) and suicide attempts among 179,771 adolescents attending school from 9 high-income, 31 middle-income, and 4 low-income countries: a cross-sectional study. J Affect Disord. 2019;248:91–8. https://doi.org/10.1016/j.jad.2019.01.033.CrossRefPubMed

76.

Nguyen KH, Padilla M, Villaveces A, Patel P, Atuchukwu V, Onotu D, Apondi R, Aluzimbi G, Chipimo P, Kancheya N. Coerced and forced sexual initiation and its association with negative health outcomes among youth: results from the Nigeria, Uganda, and Zambia violence against children surveys. Child Abuse Negl. 2019;96:104074. https://doi.org/10.1016/j.chiabu.2019.104074.CrossRefPubMedPubMedCentral

77.

Quarshie ENB, Cheataa-Plange HV, Annor F, Asare-Doku W, Lartey JKS. Prevalence of suicidal behaviour among nursing and midwifery college students in Ghana. Nursing Open. 2019;6:897–906. https://doi.org/10.1002/nop2.271.CrossRefPubMedPubMedCentral

78.

Shayo FK, Lawala PS. Does food insecurity link to suicidal behaviors among in-school adolescents? Findings from the low-income country of sub-Saharan Africa. BMC Psychiatry. 2019;19(1):227. https://doi.org/10.1186/s12888-019-2212-6.CrossRefPubMedPubMedCentral

79.

Thornton VJ, Asanbe CB, Denton ED. Clinical risk factors among youth at high risk for suicide in South Africa and Guyana. Depression Anxiety. 2019;36(5):423–32. https://doi.org/10.1002/da.22889.CrossRefPubMed

80.

Tolulope O, Olutayo A, Babatunde S, Adesanmi A. Suicidality in a non-clinical sample of Nigerian adolescents: prevalence and correlates. Suicidology Online. 2019;10(7):1–8.

81.

Uddin R, Burton NW, Maple M, Khan SR, Khan A. Suicidal ideation, suicide planning, and suicide attempts among adolescents in 59 low-income and middle-income countries: a population-based study. Lancet Child Adolescent Health. 2019;3(4):223–33. https://doi.org/10.1016/s2352-4642(18)30403-6.CrossRefPubMed

82.

Vancampfort D, Stubbs B, Mugisha J, Firth J, Van Damme T, Smith L, Koyanagi A. Leisure-time sedentary behavior and suicide attempt among 126,392 adolescents in 43 countries. J Affect Disord. 2019;250:346–53. https://doi.org/10.1016/j.jad.2019.03.053.CrossRefPubMed

83.

Cummins R, Allwood C. Suicide attempts or threats by children and adolescents in Johannesburg. S Afr Med J. 1984;66:726–9.PubMed

84.

Schlebusch L. Self-destructive behaviour in adolescents. S Afr Med J. 1985;68(11):792–5.PubMed

85.

Pillay AL. Factors precipitating parasuicide among young south African Indians. Psychol Rep. 1987;61(2):545–6. https://doi.org/10.2466/pr0.1987.61.2.545.CrossRefPubMed

86.

Pillay AL. Methods of self-destructive behaviour in adolescents and young adults. Psychol Rep. 1988;63(2):552–4. https://doi.org/10.2466/pr0.1988.63.2.552.CrossRefPubMed

87.

Pillay AL, Wassenaar DR. Rescue expectations and hopelessness in adolescent parasuicides. Percept Mot Skills. 1991;72(2):363–6. https://doi.org/10.2466/pms.1991.72.2.363.CrossRefPubMed

88.

Mhlongo T, Peltzer K. Parasuicide among youth in a general hospital in South Africa. Curationis. 1999;22(2):72–6. https://doi.org/10.4102/curationis.v22i2.735.CrossRefPubMed

89.

Yéo-Tenena YJ, Yao YP, Bakayoko AS, N'dja GR, Kouamé LM, Soro SJ, Delafosse RC. Étude descriptive des conduites suicidaires des adolescents à Abidjan (Descriptive study of suicidal adolescents conducted in Abidjan). L'Encephale. 2010;36:D41–7. https://doi.org/10.1016/j.encep.2008.08.007.CrossRefPubMed

90.

Okoko AR, Ekouya Bowassa G, Oko APG, Mbika-Cardorelle A, Dzalamou M, Moyen GM. Tentatives de suicide de l’enfant et de l’adolescent a` Brazzaville (Suicide attempts by children and teenagers in Brazzaville). Archives de Pediatrie. 2011;18(7):810–1. https://doi.org/10.1016/j.arcped.2011.04.018.CrossRefPubMed

91.

Fine G, Alison H, Van der Westhuizen D, Krüger C. Predicting frequency of suicide attempts of adolescent outpatients at Weskoppies hospital using clinical and demographic characteristics. S Afr J Psychiatry. 2012;18(1):22–6. https://doi.org/10.4102/sajpsychiatry.v18i1.271.CrossRef

92.

Devries KM, Mak JY, Bacchus LJ, Child JC, Falder G, Petzold M, Astbury J, Watts CH. Intimate partner violence and incident depressive symptoms and suicide attempts: a systematic review of longitudinal studies. PLoS Med. 2013;10(5):e1001439. https://doi.org/10.1371/journal.pmed.1001439.CrossRefPubMedPubMedCentral

93.

Serafini G, Canepa G, Adavastro G, Nebbia J, Murri MB, Erbuto D, Pocai B, Fiorillo A, Pompili M, Flouri E, et al. The relationship between childhood maltreatment and non-suicidal self-injury: a systematic review. Front Psychiatry. 2017;8. https://doi.org/10.3389/fpsyt.2017.00149.

94.

Liu RT, Scopelliti KM, Pittman SK, Zamora AS. Childhood maltreatment and non-suicidal self-injury: a systematic review and meta-analysis. Lancet Psychiatry. 2018;5(1):51–64. https://doi.org/10.1016/s2215-0366(17)30469-8.CrossRefPubMed

95.

Pillay AL, Wassenaar DR. Family dynamics, hopelessness and psychiatric disturbance in parasuicidal adolescents. Aust N Z J Psychiatry. 1997;31(2):227–31. https://doi.org/10.3109/00048679709073825.CrossRefPubMed

96.

Madu SN, Matla M-QP. Family environmental factors as correlates for adolescent suicidal behaviors in the Limpopo Province of South Africa. Soc Behav Pers Int J. 2004;32(4):341–53. https://doi.org/10.2224/sbp.2004.32.4.341.CrossRef

97.

Carvalho AF, Stubbs B, Vancampfort D, Kloiber S, Maes M, Firth J, Kurdyak PA, Stein DJ, Rehm J, Koyanagi A. Cannabis use and suicide attempts among 86,254 adolescents aged 12–15 years from 21 low-and middle-income countries. European Psychiatry. 2019;56:8–13. https://doi.org/10.1016/j.eurpsy.2018.10.006.CrossRefPubMed

98.

Osafo J, Akotia CS, Andoh-Arthur J, Quarshie EN-B. Attempted suicide in Ghana: motivation, stigma, and coping. Death Studies. 2015;39(5):274–80. https://doi.org/10.1080/07481187.2014.991955.CrossRefPubMed

99.

Kabiru CW, Izugbara CO, Beguy D. The health and wellbeing of young people in sub-Saharan Africa: an under-researched area? BMC Int Health Hum Rights. 2013;13(1):11. https://doi.org/10.1186/1472-698x-13-11.CrossRefPubMedPubMedCentral

100.

Patton GC, Sawyer SM, Santelli JS, Ross DA, Afifi R, Allen NB, Arora M, Azzopardi P, Baldwin W, Bonell C. Our future: a lancet commission on adolescent health and wellbeing. Lancet. 2016;387(10036):2423–78. https://doi.org/10.1016/S0140-6736(16)00579-1.CrossRefPubMedPubMedCentral

101.

Petroni S, Patel V, Patton G. Why is suicide the leading killer of older adolescent girls? Lancet. 2015;386(10008):2031–2. https://doi.org/10.1016/S0140-6736(15)01019-3.CrossRefPubMed

102.

Kizza D, Knizek B, Kinyanda E, Hjelmeland H. An escape from agony: a qualitative psychological autopsy study of women's suicide in a post-conflict northern Uganda. Int J Qual Stud Health Well Being. 2012;7(1):18463. https://doi.org/10.3402/qhw.v7i0.18463.CrossRef

103.

Adinkrah M. Better dead than dishonored: masculinity and male suicidal behavior in contemporary Ghana. Soc Sci Med. 2012;74(4):474–81. https://doi.org/10.1016/j.socscimed.2010.10.011.CrossRefPubMed

104.

Mucherah W, Owino E, McCoy K. Grappling with the issue of homosexuality: perceptions, attitudes, and beliefs among high school students in Kenya. Psychol Res Behav Manag. 2016;9:253–62. https://doi.org/10.2147/PRBM.S112421.CrossRefPubMedPubMedCentral

105.

Woan J, Lin J, Auerswald C. The health status of street children and youth in low-and middle-income countries: a systematic review of the literature. J Adolescent Health. 2013;53(3):314–21. e312. https://doi.org/10.1016/j.jadohealth.2013.03.013.CrossRef

106.

Patel V, Flisher AJ, Nikapota A, Malhotra S. Promoting child and adolescent mental health in low and middle income countries. J Child Psychol Psychiatry. 2008;49(3):313–34. https://doi.org/10.1111/j.1469-7610.2007.01824.x.CrossRefPubMed

107.

Moher D, Shamseer L, Clarke M, Ghersi D, Liberati A, Petticrew M, Shekelle P, Stewart LA. Preferred reporting items for systematic review and meta-analysis protocols (PRISMA-P) 2015 statement. Syst Rev. 2015;4(1):1. https://doi.org/10.1186/2046-4053-4-1.CrossRefPubMedPubMedCentral

Title: Self-harm with suicidal and non-suicidal intent in young people in sub-Saharan Africa: a systematic review
Authors: Emmanuel N-B Quarshie
Mitch G. Waterman
Allan O. House
Publication date: 01-12-2020
Publisher: BioMed Central
Keywords: Suicide
Suicide
Published in: BMC Psychiatry / Issue 1/2020
Electronic ISSN: 1471-244X
DOI: https://doi.org/10.1186/s12888-020-02587-z

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Self-harm with suicidal and non-suicidal intent in young people in sub-Saharan Africa: a systematic review

Abstract

Background

Method

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Method

Results

Conclusion

Please log in to get access to this content

Other articles of this Issue 1/2020

Recovery services and expectation of consumers and mental health professionals in community-based residential facilities of Ghana

Exploring factors of diagnostic delay for patients with bipolar disorder: a population-based cohort study

Suicidal behaviours among adolescents in Liberia

Suicidal ideation, psychopathology and associated factors among HIV-infected adults in Indonesia

Safety and efficacy of guanfacine extended-release in adults with attention-deficit/hyperactivity disorder: an open-label, long-term, phase 3 extension study

Resilience, trauma, and hopelessness: protective or triggering factor for the development of psychopathology among migrants?