Substance use in adulthood following adolescent self-harm: a population-based cohort study

Area of Science:

• Psychiatry
• Addiction Medicine
• Developmental Psychology

Background:

• Self-harm in adolescence is a significant public health concern.
• Understanding long-term sequelae of adolescent self-harm is critical for prevention and intervention.

Purpose of the Study:

• To investigate the prospective association between adolescent self-harm and adult substance use disorders.
• To determine if adolescent self-harm is an independent risk factor for heavy and dependent substance use in adulthood.

Main Methods:

• A 15-year prospective cohort study followed 1943 adolescents from Victoria, Australia.
• Data on self-harm and substance use were collected across seven follow-up waves, from adolescence to young adulthood (mean age 15.9 to 29.1 years).

Main Results:

• Adolescent self-harm was strongly associated with substance use (OR: 3.3).
• Adolescent self-harmers faced increased risk for adult substance use and dependence syndromes.
• Self-harm predicted a four-fold increase in multiple dependence syndromes (OR: 4.2), an association robust even after adjusting for anxiety/depression and adolescent substance use (aOR: 2.0).

Conclusions:

• Adolescent self-harm is an independent risk factor for developing multiple substance dependence syndromes in adulthood.
• This elevated substance misuse likely contributes to premature mortality and disease burden in individuals with a history of self-harm.