Psychological Medicine

Research Article

Adolescent suicidal behaviours: a population-based study of risk

G. C. PATTON a1 , R. HARRIS a1 , J. B. CARLIN a1 , M. E. HIBBERT a1 , C. COFFEY a1 , M. SCHWARTZ a1 and G. BOWES a1
a1 Department of Psychiatry and Department of Paediatrics, University of Melbourne, Melbourne, Victoria, Australia


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.


Address for correspondence: Dr George C. Patton, Centre for Adolescent Health, University of Melbourne, Parkville, VIC 3052, Australia.