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Minerva Psichiatrica 2014 June;55(2):83-90


language: Italian

Non-suicidal self-injury (NSSI) and suicidal behavior disorder (SBD) in DSM-5

Gargiulo A. 1, Plener P. L. 2, Baus N. 3, Margherita G. 1, Brunner R. 4, Kaess M. 4, Kapusta N. D. 3

1 Dipartimento di Studi Umanistici, Università degli Studi di Napoli Federico II, Napoli, Italia; 2 Child and Adolescent Psychiatry and Psychotherapy, University of Ulm, Ulm, Germany; 3 Suicide Research Group, Department of Psychoanalysis and Psychotherapy, Medical University of Vienna, Vienna, Austria; 4 Section of Disorders of Personality Development, Clinic for Child and Adolescent Psichiatry, Centre for Psychosocial Medicine, University of Heidelberg, Heidelberg, Germany


Non-suicidal self-injury (NSSI) and suicidal behavior disorder (SBD) have been included as diagnostic categories as conditions for further study in the diagnostic and statistical manual of mental disorders (DSM-5). Both behaviors were defined for the first time in a classificatory system to standardize further research in this field, but are not recognized as a clinical entity yet. The aim of this paper was to introduce both concepts and to address some discussions preceding their introduction in DSM-5. Further we present some data on the prevalence of NSSI and SBD. A literature research was conducted in order to compare existing studies using the published criteria for NSSI and SBD to understand the prevalence of both conditions. Globally, our results showed that the comparability of prevalence studies is limited, since different criteria for NSSI and SBD have been utilized in the years before inclusion into DSM-5. The introduction of NSSI and SBD as diagnosis will lead to a better comparability of future studies. Especially the implementation of NSSI as a diagnostic entity would allow to avoid premature labeling of adolescent patients with the diagnosis of Borderline Personality Disorder. Further, the recognition of these independent diagnoses can help to consider them as prognostic factors of psychiatric disorders, as well as risk factors for completed suicide. From the perspective of prevention, we conclude that the standardization of the definitions of both behaviors will spark urgently needed intervention studies in order to develop more specific therapeutic treatments for adolescents and adults with NSSI and SBD.

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