Suicide Risk After Self-Harm Among Adolescents, Young Adults

Adolescents have an increased risk of suicide after nonfatal self-harm.

HealthDay News — Adolescents and young adults have increased risk of suicide after nonfatal self-harm, according to a study published online in Pediatrics.

Mark Olfson, MD, MPH, from Columbia University in New York City, and colleagues followed a national cohort of 32,395 patients aged 12 to 24 years for up to 1 year after self-harm. The authors determined repeat self-harm per 1000 person-years and suicide-deaths per 100,000 person-years.

The researchers found that adolescents had a significantly higher 12-month suicide standardized mortality rate ratio after self-harm than young adults (46.0 vs 19.2). 

Compared with non-Hispanic white patients, the risks of suicide after self-harm were significantly higher for American Indians and Alaskan natives (HR, 4.69); the risks of suicide were also elevated for self-harm patients who initially used violent methods (HR, 18.04), especially firearms (HR, 35.73), compared with nonviolent self-harm methods (HR, 1.00, reference). Increased risks of repeat self-harm were seen for females vs males (HR, 1.25), patients with personality disorders (HR, 1.55), and for patients whose initial self-harm was treated in an inpatient setting (HR, 1.65) vs an emergency department (HR, 0.62) or outpatient setting (HR, 1.00; reference).

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“After nonfatal self-harm, adolescents and young adults were at markedly elevated risk of suicide,” the authors write. “Among these high-risk patients, those who used violent self-harm methods, particularly firearms, were at especially high risk underscoring the importance of follow-up care to help ensure their safety.”


Olfson M, Wall M, Wang S, et al. Suicide after deliberate self-harm in adolescents and young adults [published online March 19, 2018]. Pediatrics. doi:10.1542/peds.2017-3517