High alcohol use a strong and significant risk factor for repetitive self-harm in female and male youth: a prospective cohort study.
BACKGROUND
Deliberate self-harm (DSH) is reported by between 5 and 17% of youth aged 14-25 years. Current management measures focus on repetition prevention in high-risk groups.


OBJECTIVE
To examine risk factors and predictors of DSH and DSH repetition in a community sample, by gender.


METHODS
A prospective cohort of 20,822 young adults (aged 17-24 years) was recruited when obtaining their driving license. A random sample of 5000 was approached for follow-up 12-18 months; 2991 (60%) responded and formed the cohort for this analysis. Patterns of self-harm, using a modified Beck Suicide Inventory, were investigated with logistic regression.


RESULTS
DSH was reported by 4.1% (123/2991) at baseline. Over the following 12 months, 3.0% (90/2991) reported new instances of DSH which included 20% (25) respondents who had engaged in DSH at baseline. Psychological distress was a risk factor for engaging in DSH in the past 12 months, OR 3.55 (95% CI 2.06-6.14). Although several clinical risk factors differed between genders, high alcohol use, OR 23.6 (95% CI 3.64-153) and psychological distress, OR 4.97 (95% CI 1.08-22.9) were significant risk factors for repeat DSH in both males and females.


CONCLUSIONS
In this community cohort, 1 in 25 youth had self-harmed in the year prior; of these, 4 in 5 did not repeat DSH over the following year. High alcohol use stands out as a strong risk factor for DSH repetition. Assessing alcohol use may help clinicians identify those who are at greatest risk for repetitive self-harm.
a The George Institute for Global Health , Australia .
Alexandra L C
AL
Martiniuk
Huei-Yang
HY
Chen
Nick
N
Glozier
George
G
Patton
Teresa
T
Senserrick
Ann
A
Williamson
Mark
M
Woodward
Rebecca
R
Ivers
D000293:Adolescent; D000428:Alcohol Drinking / Q000523:psychology*; D005260:Female; D006801:Humans; D008297:Male; D011446:Prospective Studies; D012008:Recurrence; D012307:Risk Factors; D016728:Self-Injurious Behavior / Q000150:complications* / Q000523:psychology*; D012737:Sex Factors; D013315:Stress, Psychological / Q000150:complications / Q000523:psychology*; D055815:Young Adult
Deliberate self-harm; alcohol; gender; repetition; youth