Factors Associated with Non-Suicidal Self-Injury (NSSI) in Iran: A Narrative Systematic Review

Abstract

Background: Non-suicidal self-injury (NSSI) refers to the intentional damage of one's own body 'without a suicidal intent, which involves common behaviors such as cutting, burning, scratching, and hitting the body. Identifying factors associated with the development and continuity of NSSI is a research priority, as prevention is crucial. The aim of the current study was to determine factors associated with NSSI in Iran. Materials and Methods: In this systematic review, Persian databases including Barakat Knowledge Network System, Magiran, SID, and international databases including Scopus, Medline, and Web of Science were searched for relevant publications in English and Persian by using the following Medical Subject Headings search terms: "behavior self-injurious" OR "deliberate self-harm" OR "deliberate self-harm" OR "self-destructive behavior" OR "non-suicidal self-injury" AND "Iran": from 1983 until September 2019. Two independent reviewers studied the full text of the articles and extracted the main results. The results of studies were classified and presented descriptively with a narrative approach. Results: A total of 334 articles were found of which 18 articles (n= 17343) met the inclusion criteria and were reviewed. More than half of the reviewed articles were cross-sectional (n=16). Three main themes were identified: factors associated with baseline characteristics (such as age and gender); mental disorders (such as depression); and psycho-social factors associated with mental disorders (such as self-concept disturbance). Conclusion: The meaning of identified main themes shows that the most important factor in occurrence of NSSI in Iranian patients is mental health status. Since the majority of studies were cross-sectional, the data do not yet justify risk factors. Therefore, longitudinal studies with adequate methodological qualities are recommended in future studies.