title: Adolescents with suicidal and nonsuicidal self-harm: clinical characteristics and response to therapeutic assessment.
abstract: Self-harm is one of the best predictors of death by suicide, but few studies directly compare adolescents with suicidal versus nonsuicidal self-harm. Seventy adolescents presenting with self-harm (71% young women, ages 12-18 years) who participated in a randomized controlled trial were divided into suicidal and nonsuicidal self-harm categories using the Columbia Classification Algorithm of Suicide Assessment. Adolescents with suicidal self-harm were more likely than those with nonsuicidal self-harm to be young women, 22/23 (96%) versus 34/47 (72%), odds ratio (OR) = 8.33, 95% confidence interval (CI) [1.03, 50.0]; had a later age of onset of self-harm, 15.4 years vs. 13.8 years, mean difference = 1.6, 95% CI [.8, 2.43]; and used self-poisoning more often, 18/23 (78%) versus 11/47 (23%), OR = 3.43, 95% CI [2.00, 5.89]. Only those with nonsuicidal self-harm had an improvement on Children's Global Assessment Scale score following a brief therapeutic intervention, mean difference = 8.20, 95% CI [.97, 15.42]. However, there was no interaction between treatment and suicidality. There are important differences between adolescents presenting with suicidal and nonsuicidal self-harm. Suicidal self-harm in adolescence may be associated with a less favorable response to therapeutic assessment.
authors.affiliation: Department of Child and Adolescent Psychiatry, King's College London, UK. dennis.ougrin@kcl.ac.uk
authors.forename: Dennis
authors.initials: D
authors.lastname: Ougrin
authors.forename: Tobias
authors.initials: T
authors.lastname: Zundel
authors.forename: Marinos
authors.initials: M
authors.lastname: Kyriakopoulos
authors.forename: Reetoo
authors.initials: R
authors.lastname: Banarsee
authors.forename: Daniel
authors.initials: D
authors.lastname: Stahl
authors.forename: Eric
authors.initials: E
authors.lastname: Taylor
mesh_terms: D000293:Adolescent; D017668:Age of Onset; D002648:Child; D019955:Conduct Disorder / Q000453:epidemiology; D003710:Demography; D003863:Depression / Q000453:epidemiology; D005260:Female; D006801:Humans; D007406:Interview, Psychological; D016015:Logistic Models; D015995:Prevalence; D011569:Psychiatric Status Rating Scales; D016032:Randomized Controlled Trials as Topic; D016728:Self-Injurious Behavior / Q000175:diagnosis / Q000453:epidemiology* / Q000523:psychology / Q000628:therapy; D017678:Sex Distribution; D059020:Suicidal Ideation; D016896:Treatment Outcome; D014481:United States / Q000453:epidemiology