Deliberate self-harm among adolescent psychiatric outpatients in Singapore: prevalence, nature and risk factors

Background: Deliberate self-harm (DSH) is a prominent mental health concern among adolescents. Few studies have examined adolescent DSH in non-Western countries. This study examines the prevalence, types and associated risk factors of DSH in a clinical sample of adolescents in Singapore. Methods: Using a retrospective review of medical records, demographic and clinical data were obtained from 398 consecutive adolescent psychiatric outpatients (mean age = 17.5 +/- 1.4 years, range = 13-19 years) who presented at Changi General Hospital from 2013 to 2015. Results: 23.1% (n = 92) of adolescents engaged in at least one type of DSH. Cutting was the most common type of DSH reported. Females were three times more likely to engage in DSH than males. DSH was positively associated with female gender (odds ratio [OR] 5.03), depressive disorders (OR 2.45), alcohol use (OR 3.49) and forensic history (OR 3.66), but not with smoking behaviour, living arrangement, parental marital status, past abuse or family history of psychiatric illness. Conclusion: Interventions targeting adolescent DSH should also alleviate depressive symptoms, alcohol use and delinquent behaviours.