Background. Reports of adolescent suicidal behaviour have
generally derived from clinical settings but population-based studies are
likely to provide a clearer epidemiological view.
Methods. Non-fatal suicidal behaviours were studied in 1699
Australian
15- to 16-year-old secondary school students at 44 schools in the state
of
Victoria, Australia. Self-reported episodes of
self-harm were characterized using items from the Beck Suicide Intent Scale.
Results. The 12 month weighted prevalence estimate for deliberate
self-harm was 5·1%. The commonest forms were self-laceration (1·7%),
self-poisoning (1·5%) and deliberate recklessness
(1·8%). Self-poisoning and self-laceration were commoner in girls.
The
prevalence of ‘true
suicide attempts’ was 0·2%. Most self-harmers did not perceive
death
as likely, plan self-harming episodes at length or inform others of the
episodes.
Psychiatric morbidity had the strongest association with self-harm, an
association
which held for all subtypes. Antisocial behaviour
and substance abuse were associated with self-harm in girls but not boys.
Sexual
activity was independently associated with self-harm in both genders.
Conclusions. Deliberate self-harm was common but the great
majority
of episodes were not ‘true
suicide attempts’. It is, therefore, possible that attributable mortality
and morbidity may be
greater in self-harmers without definite suicidal intent.