The Relationship Between Self-Harm and Suicide in Adolescents and Young Adults

Nonsuicidal self-injury is a common development among adolescents that varies in severity, frequency, and asso-ciated psychiatric vulnerability. A key challenge is to understand how clini-cians can identify those at greater risk, specifically for transition to suicide attempts. Shared functions (eg, to es-cape negative emotions) and risk fac-tors in selected domains (eg, exposure to self-harm in others, impulsivity, can-nabis and other drug use, diminished social connections, and history of bul-lying) between self-injury and suicide can explain this association and guide interventions. General guidelines for nonsuicidal self-injury and comorbid suicidal behavior in youth include mapping its predisposing factors and psychological functions, assessing se-verity and acute risk, and elucidating context (eg, interpersonal stressors). No medication has proven effective in reducing self-harm. Outpatient psy-chological treatment is the first option to address relevant emotional, behav-ioral, and interpersonal vulnerabilities, and evidence-based treatments can be effective (eg, dialectical behavior ther-apy, mentalization-based treatment, and cognitive-behavioral therapy). [Psychiatr Ann. 2022;52(8):311-317.]