Self-mutilative behavior in adolescents who attempt suicide by overdose

Objective: To examine the cognitive/affective and behavioral symptoms of ad olescent suicide attempters with self-mutilative behavior (SMB). Method: Ad olescents evaluated after a suicide attempt that occurred between 1996 and 2000 were divided into two groups: suicide attempters with a history of SMB (n = 52) and suicide attempters without SMB (n = 43). The groups were then compared on psychiatric diagnosis, suicide intent, depression, hopelessnes s, loneliness, anger, reckless behavior, substance use, and family function ing. Results: Carving on the skin and picking at a wound were the most comm only reported SMBs, occurring in about one third of the sample. The SMB gro up was significantly more likely to be diagnosed with oppositional defiant disorder, major depression, and dysthymia and had higher scores on measures of hopelessness, loneliness, anger, risk taking, reckless behavior, and al cohol use than did the non-SMB group. Loneliness increased the odds of SMB almost 6-fold. Conclusions: Adolescent suicide attempts with SMB are associ ated with greater cognitive/affective and behavioral symptoms. Adolescent s uicide attempters should be routinely screened for SMB.