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Deliberate self harm and thoughts of suicide occur more often in
adolescents than is suggested by hospital statistics, especially among
girls. Hawton and colleagues (p 1207) studied 6020 school pupils aged
15 and 16 years. Only a minority of those reporting self harm in the
previous year had presented to hospital. Factors associated with
deliberate self harm were recent exposure to self harm by peers or
family members, drug misuse, depression, anxiety, impulsivity, and low
self esteem.