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Self-injury from early adolescence to early adulthood: age-related course, recurrence, and services use in males and females from the community


Steinhoff, Annekatrin; Ribeaud, Denis; Kupferschmid, Stephan; Raible-Destan, Nesrin; Quednow, Boris B; Hepp, Urs; Eisner, Manuel; Shanahan, Lilly (2021). Self-injury from early adolescence to early adulthood: age-related course, recurrence, and services use in males and females from the community. European Child & Adolescent Psychiatry, 30(6):937-951.

Abstract

Adolescent self-injury is a widespread public health problem, but long-term longitudinal studies from European countries are rare. Self-injury in males and sex differences are poorly understood. This study describes the prevalence, frequency, age-related course, and recurrence of, and mental health services use related to adolescent self-injury. Data came from a Swiss prospective-longitudinal cohort study (N = 1482). Adolescents (52% male) reported frequency of self-injury and mental health services use (including reasons for and types of services use, hospitalizations) at ages 13, 15, 17, and 20. Between ages 13-20, 27% of adolescents reported self-injury at least once. In males, prevalence decreased from 12 to 5%; in females self-injury peaked at age 15 (16%) and then decreased (11% at age 20). In males, recurrence of self-injury increased after age 15 (from odds ratio [OR] < 3 to OR > 10); in females, recurrence was high from age 13 onwards (OR > 5). Predictors of recurrence included childhood/early adolescent internalizing symptoms and early self-injury onset. Typically, less than half of adolescents with self-injury used mental health services. Males with self-injury used services mainly for externalizing problems, learning difficulties, and attention/concentration problems; females for depression or self-injury, family problems, and victimization. Types of services used changed with age, and adolescents with self-injury had increased rates of hospitalization. There are notable sex differences in the longitudinal course of self-injury and reasons for related mental health services use. Treating early internalizing symptoms could be a promising target for preventing recurrent self-injury. Males are at particular risk of not receiving adequate treatment for self-injury.

Abstract

Adolescent self-injury is a widespread public health problem, but long-term longitudinal studies from European countries are rare. Self-injury in males and sex differences are poorly understood. This study describes the prevalence, frequency, age-related course, and recurrence of, and mental health services use related to adolescent self-injury. Data came from a Swiss prospective-longitudinal cohort study (N = 1482). Adolescents (52% male) reported frequency of self-injury and mental health services use (including reasons for and types of services use, hospitalizations) at ages 13, 15, 17, and 20. Between ages 13-20, 27% of adolescents reported self-injury at least once. In males, prevalence decreased from 12 to 5%; in females self-injury peaked at age 15 (16%) and then decreased (11% at age 20). In males, recurrence of self-injury increased after age 15 (from odds ratio [OR] < 3 to OR > 10); in females, recurrence was high from age 13 onwards (OR > 5). Predictors of recurrence included childhood/early adolescent internalizing symptoms and early self-injury onset. Typically, less than half of adolescents with self-injury used mental health services. Males with self-injury used services mainly for externalizing problems, learning difficulties, and attention/concentration problems; females for depression or self-injury, family problems, and victimization. Types of services used changed with age, and adolescents with self-injury had increased rates of hospitalization. There are notable sex differences in the longitudinal course of self-injury and reasons for related mental health services use. Treating early internalizing symptoms could be a promising target for preventing recurrent self-injury. Males are at particular risk of not receiving adequate treatment for self-injury.

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Item Type:Journal Article, refereed, original work
Communities & Collections:04 Faculty of Medicine > Psychiatric University Hospital Zurich > Clinic for Psychiatry, Psychotherapy, and Psychosomatics
06 Faculty of Arts > Institute of Psychology
06 Faculty of Arts > Jacobs Center for Productive Youth Development
06 Faculty of Arts > Institute of Sociology
Dewey Decimal Classification:370 Education
Scopus Subject Areas:Health Sciences > Pediatrics, Perinatology and Child Health
Social Sciences & Humanities > Developmental and Educational Psychology
Health Sciences > Psychiatry and Mental Health
Uncontrolled Keywords:Adolescence; Longitudinal; Self-injury; Services use; Sex differences; Young adulthood.
Language:English
Date:1 June 2021
Deposited On:06 Jul 2020 17:24
Last Modified:23 Jun 2024 01:40
Publisher:Springer
ISSN:1018-8827
OA Status:Hybrid
Free access at:PubMed ID. An embargo period may apply.
Publisher DOI:https://doi.org/10.1007/s00787-020-01573-w
PubMed ID:32572615
  • Content: Published Version
  • Licence: Creative Commons: Attribution 4.0 International (CC BY 4.0)