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Limited data exist on training of European paediatric and adult congenital cardiologists.
Methods:
A structured and approved questionnaire was circulated to national delegates of Association for European Paediatric and Congenital Cardiology in 33 European countries.
Results:
Delegates from 30 countries (91%) responded. Paediatric cardiology was not recognised as a distinct speciality by the respective ministry of Health in seven countries (23%). Twenty countries (67%) have formally accredited paediatric cardiology training programmes, seven (23%) have substantial informal (not accredited or certified) training, and three (10%) have very limited or no programme. Twenty-two countries have a curriculum. Twelve countries have a national training director. There was one paediatric cardiology centre per 2.66 million population (range 0.87–9.64 million), one cardiac surgical centre per 4.73 million population (range 1.63–10.72 million), and one training centre per 4.29 million population (range 1.63–10.72 million population). The median number of paediatric cardiology fellows per training programme was 4 (range 1–17), and duration of training was 3 years (range 2–5 years). An exit examination in paediatric cardiology was conducted in 16 countries (53%) and certification provided by 20 countries (67%). Paediatric cardiologist number is affected by gross domestic product (R2 = 0.41).
Conclusion:
Training varies markedly across European countries. Although formal fellowship programmes exist in many countries, several countries have informal training or no training. Only a minority of countries provide both exit examination and certification. Harmonisation of training and standardisation of exit examination and certification could reduce variation in training thereby promoting high-quality care by European congenital cardiologists.
Background: Eptinezumab is a preventive migraine treatment approved in the US. We evaluated the impact of eptinezumab on acute headache medication (AHM) use in patients diagnosed with chronic migraine (CM) and medication-overuse headache (MOH) in PROMISE-2. Methods: PROMISE-2 randomized patients with CM to eptinezumab 100mg, 300mg, or placebo for 2 intravenous doses administered every 12 weeks. Trained investigators diagnosed MOH at screening using 3-month medication history and ICHD-3b criteria. Endpoints included days/month of any AHM use (days of ≥1 medication class), total AHM use (summed days for each medication class), and triptan use over Weeks 1-12 and 13-24. AHM classes included triptan, ergot, opioid, simple analgesic, and combination analgesic. Results: Of 1072 PROMISE-2 patients, 431 (40.2%) were diagnosed with MOH (100mg, n=139; 300mg, n=147; placebo, n=145). During the 28-day baseline period, mean days of any AHM was ~16.4, total AHM was ~20.4, and triptan was ~8.9 across treatment arms. Over Weeks 1-12, mean days/month of any AHM was 8.8 (100mg), 9.9 (300mg), and 11.8 (placebo); total AHM was 10.8, 12.2, and 14.8; triptan was 4.3, 4.4, and 6.4. Similar or lower rates were observed over Weeks 13-24.
Conclusions: In patients diagnosed with both CM and MOH, eptinezumab treatment reduced AHM use.
Statistical properties of the scrape-off layer plasma fluctuations are studied in ohmically heated plasmas in the Alcator C-Mod tokamak. For the first time, plasma fluctuations as well as parameters that describe the fluctuations are compared across measurements from a mirror Langmuir probe (MLP) and from gas-puff imaging (GPI) that sample the same plasma discharge. This comparison is complemented by an analysis of line emission time-series data, synthesized from the MLP electron density and temperature measurements. The fluctuations observed by the MLP and GPI typically display relative fluctuation amplitudes of order unity together with positively skewed and flattened probability density functions. Such data time series are well described by an established stochastic framework that models the data as a superposition of uncorrelated, two-sided exponential pulses. The most important parameter of the process is the intermittency parameter, $\gamma = {\tau _{d}} / {\tau _{w}}$, where ${\tau _{d}}$ denotes the duration time of a single pulse and ${\tau _{w}}$ gives the average waiting time between consecutive pulses. Here we show, using a new deconvolution method, that these parameters can be consistently estimated from different statistics of the data. We also show that the statistical properties of the data sampled by the MLP and GPI diagnostic are very similar. Finally, a synthetic GPI signal using only plasma parameters sampled by the MLP shows qualitatively different fluctuation statistics from the measured GPI signal.
The SPARC tokamak is a critical next step towards commercial fusion energy. SPARC is designed as a high-field ($B_0 = 12.2$ T), compact ($R_0 = 1.85$ m, $a = 0.57$ m), superconducting, D-T tokamak with the goal of producing fusion gain $Q>2$ from a magnetically confined fusion plasma for the first time. Currently under design, SPARC will continue the high-field path of the Alcator series of tokamaks, utilizing new magnets based on rare earth barium copper oxide high-temperature superconductors to achieve high performance in a compact device. The goal of $Q>2$ is achievable with conservative physics assumptions ($H_{98,y2} = 0.7$) and, with the nominal assumption of $H_{98,y2} = 1$, SPARC is projected to attain $Q \approx 11$ and $P_{\textrm {fusion}} \approx 140$ MW. SPARC will therefore constitute a unique platform for burning plasma physics research with high density ($\langle n_{e} \rangle \approx 3 \times 10^{20}\ \textrm {m}^{-3}$), high temperature ($\langle T_e \rangle \approx 7$ keV) and high power density ($P_{\textrm {fusion}}/V_{\textrm {plasma}} \approx 7\ \textrm {MW}\,\textrm {m}^{-3}$) relevant to fusion power plants. SPARC's place in the path to commercial fusion energy, its parameters and the current status of SPARC design work are presented. This work also describes the basis for global performance projections and summarizes some of the physics analysis that is presented in greater detail in the companion articles of this collection.
Owing to its high magnetic field, high power, and compact size, the SPARC experiment will operate with divertor conditions at or above those expected in reactor-class tokamaks. Power exhaust at this scale remains one of the key challenges for practical fusion energy. Based on empirical scalings, the peak unmitigated divertor parallel heat flux is projected to be greater than 10 GW m−2. This is nearly an order of magnitude higher than has been demonstrated to date. Furthermore, the divertor parallel Edge-Localized Mode (ELM) energy fluence projections (~11–34 MJ m−2) are comparable with those for ITER. However, the relatively short pulse length (~25 s pulse, with a ~10 s flat top) provides the opportunity to consider mitigation schemes unsuited to long-pulse devices including ITER and reactors. The baseline scenario for SPARC employs a ~1 Hz strike point sweep to spread the heat flux over a large divertor target surface area to keep tile surface temperatures within tolerable levels without the use of active divertor cooling systems. In addition, SPARC operation presents a unique opportunity to study divertor heat exhaust mitigation at reactor-level plasma densities and power fluxes. Not only will SPARC test the limits of current experimental scalings and serve for benchmarking theoretical models in reactor regimes, it is also being designed to enable the assessment of long-legged and X-point target advanced divertor magnetic configurations. Experimental results from SPARC will be crucial to reducing risk for a fusion pilot plant divertor design.
Self-interaction is the process by which a microinstability eigenmode that is extended along the direction parallel to the magnetic field interacts non-linearly with itself. This effect is particularly significant in gyrokinetic simulations accounting for kinetic passing electron dynamics and is known to generate stationary $E\times B$ zonal flow shear layers at radial locations near low-order mode rational surfaces (Weikl et al. Phys. Plasmas, vol. 25, 2018, 072305). We find that self-interaction, in fact, plays a very significant role in also generating fluctuating zonal flows, which is critical to regulating turbulent transport throughout the radial extent. Unlike the usual picture of zonal flow drive in which microinstability eigenmodes coherently amplify the flow via modulational instabilities, the self-interaction drive of zonal flows from these eigenmodes are uncorrelated with each other. It is shown that the associated shearing rate of the fluctuating zonal flows therefore reduces as more toroidal modes are resolved in the simulation. In simulations accounting for the full toroidal domain, such an increase in the density of toroidal modes corresponds to an increase in the toroidal system size, leading to a finite system size effect that is distinct from the well-known profile shearing effect.
Velocardiofacial syndrome, nowadays called 22q11 deletion syndrome (22q11DS), involves a common hemizygous interstitial microdeletion at 22q11.2. The syndrome has a highly variable expression including congenital cardiac and vascular anomalies, endocrine dysfunctions, facial dysmorphisms and an increased risk for the occurrence of a specific psychopathological phenotype.
The patient is an 18-years-old female and only child from non consanguineous parents. She was referred because of anxious preoccupations with death. Her history mentioned postnatal feeding problems, surgical correction of septal defects aged 6 months, frequent upper airway infections during childhood, developmental delay and recurrent anxieties. Her somatic phenotype was characterized by nasal speech, minor facial dysmorphisms, bilateral hypoplasia of the thenar eminence. Neuropsychiatric examination demonstrated affective instability, severe anxieties accompanied with social withdrawal, ideas of reference, perseverations and paranoid ideation. Neuropsychological assessment demonstrated executive dysfunctions, attention deficits, low social and interpersonal skills and a disharmonic intelligence profile with limited verbal capacities. Total IQ was 81 indicating low intelligence level. Laboratory analyses and MRI scanning of the brain revealed no abnormalities. A provisional clinical diagnosis of 22q11 deletion syndrome was made. Treatment with 20mg citalopram daily for 2 years resulted in complete remission of anxiety symptoms.
Routine cytogenetic investigation demonstrated a normal 46XX karyotype, and no fragile X. 22q11.2 FISH analysis showed no deletions nor did subsequent MLPA subtelomere deletion testing. SNP array analysis demonstrated a 738,8 kb distal deletion in 22q11.21q11.22.
This report demonstrates the importance of testing for 22q11.2 distal deletions in patients with a mild phenotypical presentation, etiologically suggestive for 22q11DS.
Neuroimaging studies in adults with borderline personality disorder (BPD) have reported alterations in frontolimbic areas, but cannot differentiate between alterations originating from disease and those occurring as side-effects of medication or other consequences of the disorder.
Objectives
To provide a clearer picture of the organic origins of BPD, the present study reduced such confounds by examining adolescents in the early stages of the disorder. It also examined the extent to which alterations associated with BPD are specific, or shared more broadly among other psychiatric disorders.
Methods
Sixty right-handed, female adolescents (14-18 years) participated. 20 had a DSM-IV diagnosis of BPD, 20 had a different DSM-IV defined psychiatric disorder, and 20 were healthy controls. All groups were matched for age and IQ. Images were analysed using voxel-based morphometry.
Results
No differences were found in limbic or white matter structures. Compared to healthy controls, adolescents with BPD displayed reduced gray matter in dorsolateral prefrontal cortex bilaterally and in left orbitofrontal cortex, but there were no significant differences in gray matter between BPD and other psychiatric patients. Like BPD patients, non-BPD psychiatric patients displayed significantly less gray matter in right dorsolateral prefrontal cortex compared to healthy controls.
Conclusions
These findings indicate that the prefrontal cortex is the earliest affected in the progression of BPD, but this does not distinguish it clearly from other psychiatric disorders. Alterations in limbic areas and white matter structures were not observed, but may play a later role in the progression of the illness.
Self-harming and suicidal behaviour are both well-recognized problems during adolescence. While prevalence rates are very high and still rising in most western countries, there is an extensive need for understanding childhood developmental aspects, personality factors and psychological correlates of self-harm and suicidality. Additionally, specific and effective prevention should be established regarding self-harming and suicidal behaviour as one of the largest concerns of public health during this period of life.
Objectives
To investigate the prevalence and the associated psychological and social factors of self-harming behaviour in adolescents. To evaluate a school-based intervention aimed at reducing self-harming behaviour in adolescents.
Methods
In the years 2005 and 2010 we performed one population-based, cross-sectional study including a sample of 5,759 ninth-grade students and one randomized-controlled, school-based prevention study within the large EU-consortium (SEYLE) comprising a sample-size of 1,387 students on self-harming and suicidal behaviour in Heidelberg.
Results
The data suggest that there is a strong link between social factors and occasional self-injurious behavior and, especially in repetitive self-injurious behaviour, that there is a strong association between self-injurious behaviour and suicidal behaviour as well as self-injurious behaviour and emotional and behavioural problems. Preliminary results of the randomized-controlled prevention study could reveal a decrease of self-harming behaviour in adolescents in the short-term as well as long-term-follow-up.
Conclusions
The results support a need to investigate the possible neurobiological underpinnings as well as social factors of self-harming behaviour within a longitudinal model.
The primary aim of our study was to determine the prevalence of deliberate self-harm in adolescents using an exact definition of DSH (intentional self-mutilative acts like cutting, burning and suicidal ideation, plans and attempts). Our second aim was to evaluate a wide range of internalizing (withdrawn, somatic complaints, anxiety/depression) and externalizing behavior problems (delinquency, aggression), as well as possible gender differences which may be associated with DSH.
Methods:
Self-report cross-sectional survey. A representative sample of school students of the 9th grade (n = 5759, mean age = 14.98 (SD=0.73), 49,8% female adolescents) from the Rhein-Neckar-District in Germany has been investigated.
Results:
Moderate forms of intentional self-mutilative acts in the previous year was reported by 630 of 5759 (10.9%) school students. Additional 229 (4.0%) students reported repetitive forms of self-mutilation. With regard to suicidal behaviour 14.4% of the adolescents reported suicidal ideas and 7.9% one or more suicidal attempts during their life time. Compared with participants without a history of DSH, adolescents with DSH scored significantly higher on the YSR-subscales of somatic complaints, anxiety and depressive symptoms and delinquent behaviour.
Conclusions:
Moderate forms of intentional self-mutilative acts and severe forms as well as suicidal behaviour were found to be associated with pronounced emotional and behavioral problems. In particular female adolescents are at higher risk for DSH in comparison to male adolescents. A better understanding of the associated psychiatric and psychosocial concomitants of deliberate self-harm is an important contribution for the development of prevention and intervention programs.
The primary aim of our study was to determine gender differences of the prevalence rates of suicidal behaviour (suicidal ideation, plans and attempts) and self-injurious behaviour (intentional self-mutilative acts like cutting and burning).
Method:
Self-report cross-sectional survey. A representative sample of school students of the 9th grade (n = 5759, mean age = 14.98 (SD=0.73), 49,8% female adolescents) from the Rhein-Neckar-District in Germany has been investigated.
Results:
Moderate forms of intentional self-mutilative acts in the previous year was reported by 630 of 5759 (10.9%) school students. Additional 229 (4.0%) students reported repetitive forms of self-mutilation. In comparison with the male students the risk of moderate forms of self-mutilative acts (relative risk ratio: RRR=1.60) was significantly increased for female students, for repetitive acts (RRR=2.64), respectively. With regard to suicidal behaviour 14.4% of the adolescents reported suicidal ideas and 7.9% one or more suicidal attempts during their life time. Adolescent girls who smoked demonstrated a high rate of risk for DSH; there was no significant association between smoking and DSH in adolescent boys. Compared with participants without a history of DSH, adolescents with DSH scored significantly higher on the YSR-subscales of somatic complaints, anxiety and depressive symptoms and delinquent behaviour.
Conclusion:
Moderate forms of intentional self-mutilative acts and severe forms as well as suicidal behaviour were found to be associated with pronounced emotional and behavioral problems. In particular female adolescents are at higher risk for DSH in comparison to male adolescents.
Peer relationships play a critical role in the development of adolescents, not only for the acquisition of social skills but also for the sense of personal identity and competence. Thus the quality of peer relationships influences actual and future mental health of the adolescent.
Objectives
SEYLE (Saving and Empowering Young Lives in Europe) is a randomized controlled trial, funded by the EU, evaluating interventions for mental health promotion and suicide prevention. The study comprised 12,395 high-school students from 11 European countries.
Aims
We investigated the differences on psychological problems between students with poor and good peer relationships.
Methods
1,195 adolescents (mean age 15.3 ± 0.6; 68% females) from the Molise region constituted the Italian sample. Adolescents were identified as with poor peer relationships if they never or just sometimes get along with people of their age, feel that peers like having them in the group and feel that peers were kind and helpful. Psychometric measures were used to assess mental health problems such as depression (Beck Depression Inventory II), anxiety (Zung Self-Assessment Anxiety Scale), well-being (WHO-5) and suicidal ideation (Paykel Suicide Scale).
Results
Adolescents who reported poor peer relationships scored significantly higher (p < .005) on the scales assessing depression, anxiety and suicidal ideation and significantly lower (p < .001) on the WHO-5.
Conclusions
Particularly in adolescence peer relationships may influence psychological well-being and vice versa mental health influences the openness to the others. So promoting mental health and contemporary improve social skills could lead adolescents to a better life.
Smoking among adolescents is still a major public health problem and a global concern. Early onset and long-term smoking are associated with physical and psychological health problems.
Objective
To identify risk factors and comorbidities for occasional and daily smoking among European adolescents.
Methods
In the context of the Europe-wide 'Saving and Empowering Young Lives in Europe” (SEYLE) study we surveyed 12,328 youths at the age of 13 to 17 from 11 countries. We applied questions from the Global School-Based Student Health Survey to determine nicotine consumption as well as other risk behaviors. Psychiatric symptoms were assessed by the Strengths and Difficulties Questionnaire, the Becks Depression Inventory-II, the Zung Self-Rating Anxiety Scale,the Deliberate Self-Harm Inventory and the Paykel Suicide Scale.
Results
On average 30.9% of adolescents reported daily smoking and the onset of smoking was reported by 35.3% between the age of 12 and 13 already. Multinomial logistic regression model showed significant correlations between adolescent smoking and migration background, living in single parent households, no physical activity, parental smoking and physical fights. Further it revealed significant associations of adolescent smoking with alcohol consumption, illegal drug use, anxiety, conduct problems, hyperactivity, suicidal ideation, self-injury and internet-dependence.
Conclusion
Our data show that adolescent smoking is associated with psychosocial factors, especially family setting and parental behaviors. Further, smoking and psychiatric problems are highly correlated. Therefore, early preventive measures are necessary and essential not only for adolescents but also for their parents.
Truancy is a serious public health problem that affects adolescents from all countries around the world. It negatively affects almost every aspect in the life, including physical, mental health, social and economical conditions. Young who are habitual truants are more likely to engage in at-risk behaviour like suicidal behaviours.
Objectives:
This analysis investigated the prevalence of truancy and suicidal behaviours in the Italian sample.
Aims:
to reduce truancy among European adolescents improving mental health in European high schools.
Methods:
the WE- STAY intervention carried out in 6 different European Countries. In Italy a sample of 2265 High school students (mean age 15.6±0,6; 64,4% females) was selected. Baseline evaluation of students' lifestyle, coping styles, at-risk truancy, suicidal behaviour and mental health issues was collected using a structured questionnaire.
Results:
6% has been absent from school for 7 days or more without a valid excuse during the past year (6.6% male); 20,3% as considered as truant student (three or more skipped days per month without a valid excuse in the past year). 4,6% have seriously considered taking own life during past 2 weeks have thought about suicide, and 1,2% tried to take own life in past 2 weeks. The analysis showed as correlation between skipped school and suicidal behaviour (p < .001)
Conclusions:
Teens engaging in risk behaviours are at increased odds of depression, suicidal ideation, and suicide attempts (Hallfors et al. 2004). The preliminary We-Stay data confirm the prevalence of at-risk behaviours is higher among truant students.
Truancy negatively affects almost every aspect in the life, including physical, mental health, social and economical conditions.
Objectives
To implement and evaluate outcomes of three different kinds of intervention against truancy. A mechanistic intervention to stop truancy will be used as control.
Aims
To reduce truancy among European adolescents improving mental health in European high schools.
Methods
The WE- STAY intervention carried out in 6 different European Countries. In Italy a sample of 2265 High school students (mean age 15.6 ± 0,6; 64,4% females) was selected. The students were randomized into one of four different intervention arms. Baseline evaluation of students' lifestyle, coping styles, at-risk truancy, self-harm behaviours and mental health issues was collected using a structured questionnaire.
Results
6% has been absent from school for 7 days or more without a valid excuse during the past year. 55,0% of the sample has smoked cigarettes; 7,2% drank alcohol 4 or more time during the week (13,9% male and 3,4% female). About the use of drugs, 17,4% of them used drugs at least once in a lifetime. 16% of the students started a fight at least once in a lifetime.
Conclusions
Truancy is often related to mental health problems and at-risk behaviours. The truancy has been the focus of a different policy initiatives, often ended in failure. Through the implementation of WE-STAY is possible to acquire more data on truancy prevalence and its correlated psycho-social and psychiatric aspects, as well as information on school and parents attitudes toward this phenomenon.
The study examined the developmental trajectories of deliberate self-harm behavior (e.g. of non-suicidal self-injury, suicidality and substance use) in a community sample of 514 adolescents from 14.5 to 16.5 years of age. Data were taken from the German sample of the Saving and Empowering Young Lives in Europe study (SEYLE; Wasserman et al., 2010) and its consecutive follow-up assessments. Using general growth mixture modeling, distinctive classes for each self-harm behavior were identified. The high risk non-suicidal self-injury class as well as the high risk suicidality class demonstrated high initial values with a gradual decrease over adolescence. The substance use high risk class had a low initial value and presented acceleration with time. The high overlap between the three high-risk classes supports the notion that certain personality traits such as affective dysregulation or impulsivity may underlie these three behaviors. Compared to the low or moderate risk classes, individuals belonging to high risk classes revealed significantly higher scores in the SCID-II questionnaire for DSM-IV borderline personality disorder.
According to previous studies the prevalence of adolescent depression is 4–8% both in the USA and Europe. the aim of the current study was to investigate the prevalence of adolescent depression separately in several European countries.
Method:
Data were drawn from the Saving and Empowering Young Lives in Europe (SEYLE) study, which included 11 countries (Austria, Estonia, France, Germany, Hungary, Ireland, Italy, Israel, Romania, Slovenia and Spain) and Sweden served as the coordinating centre. Depression was measured by the Beck Depression Inventory-II (BDI-II). Adolescents with a score of 20 or greater on the BDI-II were defined as depressed. Multiple imputations were conducted to address missing data.
Results:
Out of 14,115 students who consented to participate, finally 12,395 adolescents (5,568 (44.92%) boys and 6,827 (55.08%) girls) were enrolled into the study. the mean age of the students was 14.81 years (SD = .83). Significant differences were detected in the ratio of non-depressed and depressed adolescents among countries (χ2(20) = 385.352 p = .000). the prevalence of depressed adolescents ranged from 7.1% to 19.4%. the prevalence of depressed adolescents according to country in increasing order is: Hungary: 7.1%, Austria: 7.6%, Romania: 7.6%, Estonia: 7.9%, Ireland: 8.5%, Spain: 8.6%, Italy: 9.2%, Slovenia: 11.4%, Germany: 12.9%, France: 15.4%, Israel: 19.4%.
Conclusion:
Based on a screening tool our data underlines the importance of taking account country specific prevalence rates of adolescent depression.
Corollary discharges (CDs) are the reason most people cannot tickle themselves. They are the brain's way of distinguishing whether a stimulus is associated with one's own actions or something else. In neural terms, CDs are copies of motor plans that are propagated to sensory cortex where they can be compared with inputs. A range of phenomena associated with schizophrenia from auditory hallucinations to visual processing difficulties to the ability of patients to tickle themselves can be explained as pathologies in CD mechanisms. Auditory hallucinations for example involve patients failing to perceive themselves as the author of their own inner speech.
Objectives and aims
To test whether schizophrenia is associated with a structural network disruption that could impair CD signals involved in language processing, adolescents with schizophrenia were examined using magnetic resonance imaging and compared to healthy controls.
Methods
A graph theoretical approach was used to analyse the connectivity in networks centered on:
– Broca's area;
– Wernicke's area.
Connectivity information was acquired using diffusion tensor imaging (DTI).
Results
Compared to healthy controls, adolescents with schizophrenia displayed a lower average degree of connectivity with the left inferior frontal gyrus (Broca's area). No significant differences were found in the degree of connectivity with the right inferior frontal gyrus and the superior temporal gyrus bilaterally (Wernicke's area).
Conclusions
The results suggest a link between schizophrenia and impairment to areas where CDs associated with inner speech plausibly originate.
Disclosure of interest
The authors have not supplied their declaration of competing interest.
Epidemiological studies indicate a high prevalence of self-injurious behavior in adolescents in the general population. So far, there are only very few studies on the course of self-injurious behavior in adolescents and young adults.
Objectives
The aim of the present population-based study was the analysis of prospective predictors of onset, maintenance and cessation self-injurious behavior in adolescents.
Methods
A representative sample of the normal population of adolescents from Germany (initial sample: n = 1444; mean age = 14.7, SD = 0.80, 52% female adolescents) was studied over a two years period on 4 consecutive points of measurement in the context of the European school-based intervention study SEYLE.
Results
There was a high remission rate (70.4%) of self-injurious behaviors at 24-month follow-up investigation. However, there was a substantial rate (29.6%) of adolescents who continued the self-injurious behavior, as well as a group of “new starters”. Self-injurious behavior during the baseline examination proved to be the strongest predictor of self-injurious behavior 2 years later. The extent of depressive symptoms and quality of peer relationships were significantly associated with maintaining self-injurious behavior two years later. Furthermore continued self-injurious behavior over the first 12-month was highly associated with suicide plans/suicide attempts at 24-month follow-up investigation.
Conclusions
While both, onset and maintenance of SIB are prospectively associated with an increased risk for suicidal behaviour in late adolescence, SIB cessation significantly reduces the risk for later suicidal behaviour.
Disclosure of interest
The authors have not supplied their declaration of competing interest.