Editorials

Self harm in young people

BMJ 2014; 349 doi: https://doi.org/10.1136/bmj.g6204 (Published 21 October 2014) Cite this as: BMJ 2014;349:g6204
  1. Allan House, professor of liaison psychiatry
  1. 1Leeds Institute of Health Sciences, Leeds LS2 9LJ, UK
  1. a.o.house{at}leeds.ac.uk

A worrying problem about which we know far too little

Much of what is known about non-fatal self harm and its outcomes is derived from research in people who have presented to hospital for physical treatment immediately after an act; few community based longitudinal studies exist. This is unfortunate because many episodes of self harm—especially those concerning young people—do not lead to hospital presentation. The linked paper (doi:10.1136/bmj.g5954) by Mars and colleagues based on the Avon Longitudinal Study of Parents and Children (ALSPAC) birth cohort is therefore welcome, offering a rare five year follow-up of young people between the ages of 16 and 21 years.1

Suicide is rare in adolescence,2 and over time non-fatal acts tend to decrease in frequency—both findings endorsed by Mars and colleagues’ study. Otherwise the news is not so good. At follow-up those who reported self harm at any age up to 16 years were substantially more likely than those with no history of self harm to report repeated acts of self harm; to have current mental health problems (mainly depression and anxiety), difficulties with substance misuse, and lower levels of educational attainment; and were also less …

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