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Cited by 607Suicide and Self-Harm StudiesHomicide, Infanticide, and Child AbuseInjury Epidemiology and Prevention

The natural history of self-harm from adolescence to young adulthood: A population-based cohort study

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Moran, Paul, Coffey, Carolyn, Romaniuk, Helena, Olsson, Craig, Borschmann, Rohan, Carlin, John B, Patton, George C·2012·The Lancet
DOI 10.1016/s0140-6736(11)61141-0
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Abstract

Background Knowledge about the natural history of self-harm is scarce, especially during the transition from adolescence to young adulthood, a period characterised by a sharp rise in self-inflicted deaths. From a repeated measures cohort of a representative sample, we describe the course of self-harm from middle adolescence to young adulthood.Methods A stratified, random sample of 1943 adolescents was recruited from 44 schools across the state of Victoria, Australia, between August, 1992, and January, 2008. We obtained data pertaining to self-harm from questionnaires and telephone interviews at seven waves of follow-up, commencing at mean age 15·9 years (SD 0·49) and ending at mean age 29·0 years (SD 0·59). Summary adolescent measures (waves three to six) were obtained for cannabis use, cigarette smoking, high-risk alcohol use, depression and anxiety, antisocial behaviour and parental separation or divorce.Findings 1802 participants responded in the adolescent phase, with 149 (8%) reporting self-harm, More girls (95/947 [10%]) than boys (54/855 [6%]) reported self-harm (risk ratio 1·6, 95% CI 1·2-2·2). We recorded a substantial reduction in the frequency of self-harm during late adolescence. 122 of 1652 (7%) participants who reported self-harm during adolescence reported no further self-harm in young adulthood, with a stronger continuity in girls (13/888) than boys (1/764). During adolescence, incident self-harm was independently associated with symptoms of depression and anxiety (HR 3·7, 95% CI 2·4-5·9), antisocial behaviour (1·9, 1·1-3·4), high-risk alcohol use (2·1, 1·2-3·7), cannabis use (2·4, 1·4-4·4), and cigarette smoking (1·8, 1·0-3·1). Adolescent symptoms of depression and anxiety were clearly associated with incident self-harm in young adulthood (5·9, 2·2-16).Interpretation Most self-harming behaviour in adolescents resolves spontaneously. The early detection and treatment of common mental disorders during adolescence might constitute an important and hitherto unrecognised component of suicide prevention in young adults.Funding National Health and Medical Research Council, Australia, and operational infrastructure support programme, Government of Victoria, Australia.

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Authors
Moran, P., Coffey, C., Romaniuk, H., Olsson, C., Borschmann, R., Carlin, J. B., & Patton, G. C.
Affiliations
  • King's College London (GB)
  • Murdoch Children's Research Institute (AU)
  • Royal Children's Hospital (AU)
  • Deakin University (AU)
Corresponding author
Moran, Paul
ORCID
Venue
The Lancet
Publisher
Elsevier BV
Published
2012-01
Volume
379
Issue
9812
Pages
236-243
ISSN
  • 0099-5355 (ISSN-L)
  • 0140-6736
DOI
10.1016/s0140-6736(11)61141-0
OpenAlex
W2131239415
Cited by
607
References
41
Citations by year
2026: 24 · 2025: 29 · 2024: 45 · 2023: 54 · 2022: 39 · 2021: 64 · 2020: 56 · 2019: 35 · 2018: 37 · 2017: 42 · 2016: 45 · 2015: 41 · 2014: 34 · 2013: 35 · 2012: 23
FWCI
32.81
Type
journal article
Language
en
Open access
Licence
Locations
  • The Lancet (publishedVersion)
  • PubMed (publishedVersion)
  • Minerva Access (University of Melbourne) (submittedVersion)
  • Research Portal (King's College London) (submittedVersion)
  • Explore Bristol Research (submittedVersion, other-oa)
  • Bristol Research (University of Bristol) (submittedVersion, other-oa)
Funders
National Health and Medical Research Council
Topics
  • Social Sciences › Psychology › Clinical Psychology › Suicide and Self-Harm Studies
  • Social Sciences › Sociology and Political Science › Homicide, Infanticide, and Child Abuse
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Injury Epidemiology and Prevention
Keywords
self-harm, adolescent self-harm, early adulthood, natural history (disease), depression, anxiety, antisocial behavior, alcohol consumption, cannabis use, cigarette smoking, suicide prevention, sex differences
MeSH terms
Adolescent, Adult, Female, Humans, Male, Surveys and Questionnaires, Risk Factors, Risk-Taking, Victoria, Self-Injurious Behavior, Young Adult

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