Conflict of interest statement: No conflicts declared.
Deliberate self-harm within an international community sample of young people: comparative findings from the Child & Adolescent Self-harm in Europe (CASE) Study
Article first published online: 10 MAR 2008
© 2008 The Authors. Journal compilation © 2008 Association for Child and Adolescent Mental Health
Journal of Child Psychology and Psychiatry
Volume 49, Issue 6, pages 667–677, June 2008
How to Cite
Madge, N., Hewitt, A., Hawton, K., Wilde, E. J. d., Corcoran, P., Fekete, S., Heeringen, K. v., Leo, D. D. and Ystgaard, M. (2008), Deliberate self-harm within an international community sample of young people: comparative findings from the Child & Adolescent Self-harm in Europe (CASE) Study. Journal of Child Psychology and Psychiatry, 49: 667–677. doi: 10.1111/j.1469-7610.2008.01879.x
- Issue published online: 19 MAY 2008
- Article first published online: 10 MAR 2008
- Manuscript accepted 12 November 2007
- gender differences;
Background: Deliberate self-harm among young people is an important focus of policy and practice internationally. Nonetheless, there is little reliable comparative international information on its extent or characteristics. We have conducted a seven-country comparative community study of deliberate self-harm among young people.
Method: Over 30,000 mainly 15- and 16-year-olds completed anonymous questionnaires at school in Australia, Belgium, England, Hungary, Ireland, the Netherlands and Norway. Study criteria were developed to identify episodes of self-harm; the prevalence of self-harm acts and thoughts, methods used, repetition, reasons given, premeditation, setting for the act, associations with alcohol and drugs, hospitalisation, and whether other people knew, were examined.
Results: Self-harm was more than twice as common among females as males and, in four of the seven countries, at least one in ten females had harmed herself in the previous year. Additional young people had thought of harming themselves without doing so. More males and females in all countries except Hungary cut themselves than used any other method, most acts took place at home, and alcohol and illegal drugs were not usually involved. The most common reasons given were ‘to get relief from a terrible state of mind’ followed by ‘to die’, although there were differences between those cutting themselves and those taking overdoses. About half the young people decided to harm themselves in the hour before doing so, and many did not attend hospital or tell anyone else. Just over half those who had harmed themselves during the previous year reported more than one episode over their lifetime.
Conclusions: Deliberate self-harm is a widespread yet often hidden problem in adolescents, especially females, which shows both similarities and differences internationally.