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Rates of suicide, nonfatal self-harm differ by sex, age among teens

Galit Geulayov

Results of a retrospective study in England showed that ratios of fatal to nonfatal self-harm rates differed between boys and girls, with higher incidence of suicide in boys and higher incidence of self-harm in girls, and between younger and older adolescents, according to recent findings.

“Our study underscores the need for effective clinical services which are readily accessible for those adolescents who present to clinical services,” Galit Geulayov, PhD, from the Centre for Suicide Research at University of Oxford, told Healio Psychiatry. “The study also demonstrates the need for early interventions and prevention initiatives to address self-harm by adolescents in the community, particularly through evidence-based school programs and help via internet-based resources.”

Because limited data exist on the relative incidence of fatal and nonfatal self-harm in young people, researchers evaluated the incidence of suicide, hospital-presenting nonfatal self-harm and community-occurring nonfatal self-harm among adolescents in England. They used national mortality statistics and hospital monitoring data for five hospitals taken between Jan. 1, 2011, and Dec. 31, 2013, as well as data from a 2015 school survey to estimate the incidence of fatal and nonfatal self-harm per 100,000 person-years in teenagers aged 12 to 17 years, describing these rates in terms of an iceberg model of self-harm.

Overall, 171 adolescents aged 12 to 17 years died by suicide in England (119 male and 133 aged 15 to 17 years) and 1,320 presented to hospitals following nonfatal self-harm (1,028 female and 977 aged 15 to 17 years). In 2015, 322 of 5,506 surveyed teenagers reported self-harm in the past year in the community, 250 of whom were female and 164 of whom were aged 15 to 17 years.

Among teens aged 12 to 14 years, for every male who died by suicide, 109 went to the hospital following self-harm and 3,067 reported self-harm in the community; comparatively, for every girl who died by suicide, 1,255 went to the hospital for self-harm and 21,995 reported self-harm in the community. Among teens aged 15 to 17 years, for every male suicide, 120 presented with self-harm at a hospital and 838 reported self-harm in the community; comparatively for every female suicide, 919 presented with self-harm at a hospital and 6,406 reported self-harm in the community.

“The findings of our study highlight that nonfatal self-harm is common in adolescence, especially in adolescent girls. A large number of adolescents present to hospital following self-harm and many more self-harm in the community and do not present to clinical services. Self-harm in community appears to be as common in younger as in older adolescents.” Geulayov told Healio Psychiatry. “While suicide in adolescents is fairly rare, services should also be available to support those individuals affected when adolescents die by suicide; such deaths are usually devastating for families, friends, fellow students, school staff and whole communities.” – by Savannah Demko

Disclosures: Geulayov reports no relevant financial disclosures. Please see the study for all other authors’ relevant financial disclosures.