TY - JOUR
T1 - The natural history of self-harm from adolescence to young adulthood
T2 - a population-based cohort study
AU - Moran, Paul A
AU - Coffey, Carolyn
AU - Romaniuk, Helena
AU - Olsson, Craig A.
AU - Borschmann, Rohan
AU - Carlin, John B
AU - Patton, George C.
PY - 2012/1/21
Y1 - 2012/1/21
N2 - BackgroundKnowledge about the
natural history of self-harm is scarce, especially during the transition
from adolescence to young adulthood, a period characterised by a sharp
rise in self-inflicted deaths. From a repeated measures cohort of a
representative sample, we describe the course of self-harm from middle
adolescence to young adulthood.MethodsA
stratified, random sample of 1943 adolescents was recruited from 44
schools across the state of Victoria, Australia, between August, 1992,
and January, 2008. We obtained data pertaining to self-harm from
questionnaires and telephone interviews at seven waves of follow-up,
commencing at mean age 15·9 years (SD 0·49) and ending at mean age 29·0
years (SD 0·59). Summary adolescent measures (waves three to six) were
obtained for cannabis use, cigarette smoking, high-risk alcohol use,
depression and anxiety, antisocial behaviour and parental separation or
divorce.Findings1802
participants responded in the adolescent phase, with 149 (8%) reporting
self-harm, More girls (95/947 [10%]) than boys (54/855 [6%]) reported
self-harm (risk ratio 1·6, 95% CI 1·2–2·2). We recorded a substantial
reduction in the frequency of self-harm during late adolescence. 122 of
1652 (7%) participants who reported self-harm during adolescence
reported no further self-harm in young adulthood, with a stronger
continuity in girls (13/888) than boys (1/764). During adolescence,
incident self-harm was independently associated with symptoms of
depression and anxiety (HR 3·7, 95% CI 2·4–5·9), antisocial behaviour
(1·9, 1·1–3·4), high-risk alcohol use (2·1, 1·2–3·7), cannabis use (2·4,
1·4–4·4), and cigarette smoking (1·8, 1·0–3·1). Adolescent symptoms of
depression and anxiety were clearly associated with incident self-harm
in young adulthood (5·9, 2·2–16).InterpretationMost
self-harming behaviour in adolescents resolves spontaneously. The early
detection and treatment of common mental disorders during adolescence
might constitute an important and hitherto unrecognised component of
suicide prevention in young adults.FundingNational
Health and Medical Research Council, Australia, and operational
infrastructure support programme, Government of Victoria, Australia.
AB - BackgroundKnowledge about the
natural history of self-harm is scarce, especially during the transition
from adolescence to young adulthood, a period characterised by a sharp
rise in self-inflicted deaths. From a repeated measures cohort of a
representative sample, we describe the course of self-harm from middle
adolescence to young adulthood.MethodsA
stratified, random sample of 1943 adolescents was recruited from 44
schools across the state of Victoria, Australia, between August, 1992,
and January, 2008. We obtained data pertaining to self-harm from
questionnaires and telephone interviews at seven waves of follow-up,
commencing at mean age 15·9 years (SD 0·49) and ending at mean age 29·0
years (SD 0·59). Summary adolescent measures (waves three to six) were
obtained for cannabis use, cigarette smoking, high-risk alcohol use,
depression and anxiety, antisocial behaviour and parental separation or
divorce.Findings1802
participants responded in the adolescent phase, with 149 (8%) reporting
self-harm, More girls (95/947 [10%]) than boys (54/855 [6%]) reported
self-harm (risk ratio 1·6, 95% CI 1·2–2·2). We recorded a substantial
reduction in the frequency of self-harm during late adolescence. 122 of
1652 (7%) participants who reported self-harm during adolescence
reported no further self-harm in young adulthood, with a stronger
continuity in girls (13/888) than boys (1/764). During adolescence,
incident self-harm was independently associated with symptoms of
depression and anxiety (HR 3·7, 95% CI 2·4–5·9), antisocial behaviour
(1·9, 1·1–3·4), high-risk alcohol use (2·1, 1·2–3·7), cannabis use (2·4,
1·4–4·4), and cigarette smoking (1·8, 1·0–3·1). Adolescent symptoms of
depression and anxiety were clearly associated with incident self-harm
in young adulthood (5·9, 2·2–16).InterpretationMost
self-harming behaviour in adolescents resolves spontaneously. The early
detection and treatment of common mental disorders during adolescence
might constitute an important and hitherto unrecognised component of
suicide prevention in young adults.FundingNational
Health and Medical Research Council, Australia, and operational
infrastructure support programme, Government of Victoria, Australia.
UR - http://www.scopus.com/inward/record.url?scp=84856183864&partnerID=8YFLogxK
U2 - 10.1016/S0140-6736(11)61141-0
DO - 10.1016/S0140-6736(11)61141-0
M3 - Article (Academic Journal)
C2 - 22100201
AN - SCOPUS:84856183864
SN - 0140-6736
VL - 379
SP - 236
EP - 243
JO - Lancet
JF - Lancet
IS - 9812
ER -
