Background:
Substantial numbers of adolescents self-harm, but the majority of cases do not reach the attention of medical services, making community studies essential. The prevalence of suicidal thoughts and plans at this age, and the inter-relationships between suicidal thoughts, plans and self-harm remain largely unexplored.MethodCross-sectional analysis of a postal survey of the Avon Longitudinal Study of Parents and Children (ALSPAC) birth cohort, England. Respondents (n=4810) were aged 16-17 years old.
Results:
Of all respondents, 905 (18.8%) had ever self-harmed – one quarter of whom wanted to die in their most recent episode – 15.8% had ever thought of killing themselves, and 4.3% had ever made plans to do so. Among those who had self-harmed and wanted to die, 90.4% had ever had suicidal thoughts, compared to 37.6% of those who had self-harmed but not wanted to die, and 7.8% of those who had never self-harmed (chi-square statistic =102.3, p<0.001). Those who self-harmed with and without desire to die were also at substantially increased risk of suicidal plans (52.8% and 8.7% respectively compared to 0.7%, 2 =166.9, p<0.001). As the frequency of self-harm increased, so did the risk of suicidal thoughts and plans.
Conclusions:
Self-harm and suicidal thoughts are common among 16/17 year olds, and may be on the increase. Although the majority of self-harm behaviour is not accompanied by a desire to die, those who self-harm both with and without a desire to die are at greatly increased risk of suicidal thoughts and plans.