Substance use in adulthood following adolescent self-harm: a population-based cohort study
Open accessAbstract
OBJECTIVE: To determine whether adolescents who self-harm are at increased risk of heavy and dependent substance use in adulthood. METHOD: Fifteen-year prospective cohort study of a random sample of 1943 adolescents recruited from secondary schools across the state of Victoria, Australia. Data pertaining to self-harm and substance use was obtained at seven waves of follow-up, from mean age 15.9 years to mean age 29.1 years. RESULTS: Substance use and self-harm were strongly associated during the adolescent years (odds ratio (OR): 3.3, 95% CI 2.1-5.0). Moreover, adolescent self-harmers were at increased risk of substance use and dependence syndromes in young adulthood. Self-harm predicted a four-fold increase in the odds of multiple dependence syndromes (sex- and wave-adjusted OR: 4.2, 95% CI: 2.7-6.6). Adjustment for adolescent anxiety/depression attenuated but did not eliminate most associations. Adolescent substance use confounded all associations, with the exception of multiple dependence syndromes, which remained robustly associated with adolescent self-harm (fully adjusted odds ratio: 2.0, 95% CI: 1.2-3.2). CONCLUSION: Adolescent self-harm is an independent risk factor for multiple dependence syndromes in adulthood. This level of substance misuse is likely to contribute substantially to the premature mortality and disease burden experienced by individuals who self-harm.
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Self-citation
- Authors
- Moran, P., Coffey, C., Romaniuk, H., Degenhardt, L., Borschmann, R., & Patton, G. C.
- Affiliations
- King's College London (GB)
- Royal Children's Hospital (AU)
- The University of Melbourne (AU)
- Corresponding author
- Moran, P.
- Venue
- Acta Psychiatrica Scandinavica
- Publisher
- Wiley
- Published
- 2014-06-23
- Volume
- 131
- Issue
- 1
- Pages
- 61-68
- ISSN
- 0001-690X (ISSN-L)
- 1600-0447
- PMC
- PMC4293154
- OpenAlex
- W2080889530
- Cited by
- 86
- References
- 39
- Citations by year
- 2026: 3 · 2025: 7 · 2024: 5 · 2023: 9 · 2022: 9 · 2021: 8 · 2020: 14 · 2019: 5 · 2018: 9 · 2017: 6 · 2016: 4 · 2015: 2 · 2014: 3 · 2013: 1
- FWCI
- 5.90
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- Locations
- Acta Psychiatrica Scandinavica (publishedVersion, cc-by-nc-nd)
- PubMed Central (publishedVersion, cc-by-nc-nd)
- PubMed (publishedVersion)
- Bristol Research (University of Bristol) (publishedVersion, other-oa)
- Minerva Access (University of Melbourne) (submittedVersion, cc-by-nc-nd)
- Figshare (submittedVersion, cc-by)
- Research Portal (King's College London) (submittedVersion, other-oa)
- Explore Bristol Research (submittedVersion, other-oa)
- Funders
- South London and Maudsley NHS Foundation Trust
- National Institute for Health and Care Research
- King's College London
- Topics
- Social Sciences › Psychology › Clinical Psychology › Suicide and Self-Harm Studies
- Health Sciences › Medicine › Epidemiology › Substance Abuse Treatment and Outcomes
- Social Sciences › Sociology and Political Science › Homicide, Infanticide, and Child Abuse
- Keywords
- adolescent self-harm, substance use, substance dependence, early adulthood, heavy alcohol use, premature mortality
- MeSH terms
- Adolescent, Adolescent Behavior, Adult, Age Factors, Female, Humans, Male, Prospective Studies, Surveys and Questionnaires, Risk Factors, Victoria, Cohort Studies, Comorbidity, Odds Ratio, Self-Injurious Behavior, Substance-Related Disorders, Young Adult
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