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Substance Abuse, Self-Harm Predict Suicide Attempt in High-Risk Teens

April 12, 2019

Substance abuse, self-harm or exposure to it, and certain personality traits are among predictors of future suicide attempt in high-risk young people, researchers found in a study published online in The Lancet Psychiatry.

“While suicidal thoughts and self-harm are common in young people, with around 1 in 6 young people reporting self-harm, suicide and suicide attempts are thankfully relatively rare,” said researcher David Gunnell, DSc, professor of epidemiology at the University of Bristol in England. “Being better able to identify those at greatest risk and intervening may help reduce suicides in young people.”

Researchers analyzed questionnaire data for 310 adolescents who experienced suicidal thoughts and 380 adolescents who engaged in nonsuicidal self-harm at age 16. By age 21, 12% of participants in each group had attempted suicide.

Among 16-year-olds with suicidal thoughts, factors that best predicted a suicide attempt over the next 5 years were nonsuicidal self-harm, cannabis or other illicit drug use, exposure to self-harm in friends or family, and having a personality type open to new ideas and experiences, according to the study.

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Among 16-year-olds with nonsuicidal self-harm, the strongest predictors of suicide attempt by age 21 were cannabis or other illicit drug use, sleep problems such as waking in the night or insufficient sleep, and lower levels of extraversion.

Researchers noted that many commonly cited risk factors were not linked with transition to suicide attempt in their analysis of high-risk adolescents.

Their study also found that adolescents who at age 16 reported both suicidal thoughts and nonsuicidal self-harm were at highest risk of future suicide attempt, with 1 in 5 attempting suicide by age 21.

“We’re now planning studies to look at predictors during shorter time frames (hours/days/weeks) and to look at other predictors which are not covered in this study,” said researcher Becky Mars, PhD, of the University of Bristol. “This is important as many well-established risk factors for suicide (such as mental health problems) do not predict suicide attempts in these high-risk groups.”

—Jolynn Tumolo


Mars B, Heron J, Klonsky ED, et al. Predictors of future suicide attempt among adolescents with suicidal thoughts or non-suicidal self-harm: a population-based birth cohort study. The Lancet Psychiatry. 2019 March 11;[Epub ahead of print].

Bristol provides first long-term look at predictors of suicide attempts [press release]. Bristol, United Kingdom: University of Bristol; March 14, 2019.

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