J Affect Disord. 2026 Jan 30:121316. doi: 10.1016/j.jad.2026.121316. Online ahead of print.
ABSTRACT
INTRODUCTION: This study aims to assess the secular trend of self-injurious behavior (SIB) in PTSD and evaluate the effect of the COVID-19 pandemic on SIB in PTSD.
METHODS: The Nationwide Inpatient Sample (NIS) database 2017-2022 was used to analyze the secular trend of SIB in PTSD (N = 35,892,123). The ICD-10-CM code was used to define PTSD, suicide attempts, non-suicidal self-injury (NSSI), and psychiatric comorbidities. Logistic regression was used to estimate the odds ratio of SIB in PTSD and assess the association between potential covariates and SIB. An interrupted time series analysis (ITSA) model was applied to assess the long-term and short-term effect of the COVID-19 pandemic on SIB. Stratification by age was conducted to compare the secular trend of SIB by age.
RESULTS: Both suicide attempts and NSSI were more prevalent in PTSD patients than in control. Logistic regression showed that patients with PTSD had higher odds of SIB, which were significantly attenuated after adjusting for covariates. A constant decline in the prevalence of suicide attempts was detected, but the rate of decrease was attenuated during the COVID-19 pandemic. In contrast, the prevalence of NSSI acutely increased after the onset of COVID-19 but gradually regressed to the baseline prevalence as time progressed. The changes in SIB during the pandemic were most prominent in participants aged 17 or younger.
DISCUSSION: The COVID-19 pandemic had both immediate and sustained effects on SIB in PTSD. SIB in younger generations was most prominently influenced by the pandemic.
PMID:41621441 | DOI:10.1016/j.jad.2026.121316
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