Quality Assessment Tool Used to Assess Located Studies Including Scoring Criteria.

<p>Quality Assessment Tool Used to Assess Located Studies Including Scoring Criteria.</p

Frequencies of Each Score on Quality Assessment Tool of Located Studies (n = 129).

<p>Frequencies of Each Score on Quality Assessment Tool of Located Studies (n = 129).</p

Forest plot of sensitivity and specificity of personality disorder in predicting repetition.

<p>Forest plot of sensitivity and specificity of personality disorder in predicting repetition.</p

Forest plot of sensitivity and specificity of previous self-harm in predicting repetition.

<p>Forest plot of sensitivity and specificity of previous self-harm in predicting repetition.</p

Frequencies of Each Score on Quality Assessment Tool of Located Studies (n = 129).

<p>Frequencies of Each Score on Quality Assessment Tool of Located Studies (n = 129).</p

Flowchart of included studies.

<p>Flowchart of included studies.</p

Demographic and clinical characteristics according to recommended next care received.

<p>Demographic and clinical characteristics according to recommended next care received.</p

Regional variation of recommended next care of hospital-treated self-harm by HSE Hospital Group, average 2004–2012.

<p>Regional variation of recommended next care of hospital-treated self-harm by HSE Hospital Group, average 2004–2012.</p

Multinomial logistic regression analysis of the independent associations of factors and recommended next care following hospital-treated self-harm.

<p>Multinomial logistic regression analysis of the independent associations of factors and recommended next care following hospital-treated self-harm.</p

Risk and protective factors for self-harm in adolescents and young adults: an umbrella review of systematic reviews

We conducted an umbrella review to synthesise the evidence from systematic reviews and meta-analyses that examined the risk and protective factors for self-harm in young people. We searched six different databases and used the AMSTAR-2 checklist for quality assessment. The importance of each risk and protective factor was determined based on (1) the number of times it was identified by general reviews examining any risk or protective factor, and (2) the effect sizes from meta-analyses. There were 61 systematic reviews included in this review. The most frequently identified risk factors for self-harm in young people included childhood abuse, depression/anxiety, bullying, trauma, psychiatric illnesses, substance use/abuse, parental divorce, poor family relationships, lack of friends, and exposure to self-harm behaviour in others. The risk factors with the strongest evidence for an association with self-harm were behavioural disorders, personality disorders and depression or anxiety. There was a dearth of systematic reviews examining protective factors but good family/friend relationships were most frequently identified. There was also evidence to show that non-suicidal and suicidal self-harm shared many of the same risk factors. Clinicians and other professionals who work with young people should be particularly cognisant of the psychiatric and adverse life event risk factors as well as the substance use, education-related and individual-level (e.g. being LGB) risk factors for self-harm. Knowledge of risk factors for self-harm can potentially be used to inform the design and implementation of prevention measures and further research is needed on the protective factors for self-harm.</p