New research in the April 2018 Pediatrics found that youths treated for deliberate, but non-suicidal self-harm, such as cutting, were more than 25 times as likely than demographically matched peers to die from suicide within the following year.

The study, “Suicide Following Deliberate Self-Harm in Adolescents and Young Adults” (published online March 19), followed 32,395 patients between ages 12 and 24 who were enrolled in Medicaid between 2001 and 2007. The risk of suicide within a year of self-harm varied considerably by age, race, and other factors. It was more than four times higher for males (338.8 per 100,000) than for females (80.2 per 100,000).

In addition, the risk was markedly higher for American Indians/Alaskan Natives than for non-Hispanic white patients, and for patients who used more violent methods of self-harm, especially firearms. The study also revealed differences among adolescents and young adults who were treated for the initial self-harm.

Although depression and anxiety diagnoses were common in both age groups, for example, adolescents with self-harm were far more likely to have been recently diagnosed with attention deficit hyperactivity disorder and other disruptive behaviors, while young adults more commonly had substance use and personality disorder diagnoses. Authors of the study said their findings underscore the importance of follow-up care for youths treated for self-harm to help ensure their safety.