prevalence of self-harm behaviors and deliberate self-cutting in high school students in northern iran and its relationship with anxiety, depression, and stress

Introduction: self-harm has increased among adolescents in recent years, turning it to one of the major public and mental health concerns.objective: the present study aims to investigate the prevalence of self-harm and deliberate selfcutting in high school students in northern iran, and its relationship with anxiety, depression, and stress.materials and methods: in this analytical cross-sectional study, participants were 617 high school students in rasht, iran in 2018 who were selected through multistage cluster random sampling. data collection tools were a demographic form, the self-harm inventory (shi), and the 21-item depression, anxiety, and stress scale (dass-21). data analysis was done by independent t-test, kruskal–wallis test, one-way analysis of variance, chi-square test, fisher’s exact test, and linear and logistic regression.results: the mean age of students was 16.11±1.35 years, and the majority of them were male (64.2%). the prevalence of self-harm behaviors was 54.9% (n=339), 20.3% in females and 79.7% in males. deliberate self-cutting was found in 11% of students. the score of shi was significantly higher in boys than in girls, while the prevalence of deliberate self-cutting was more in girls (p=0.001). self-harm behaviors increased with increasing depression, anxiety, and stress (p=0.001). gender (b=0.704, 95%ci; 0.149-1.258, p=0.013), grade (b=-1.011, 95%ci;-1.517- -0.504, p=0.001), family size (b=0.620, 95%ci; 0.344-0.895, p=0.001), age (b=0.624, 95%ci; 0.286-0.962, p=0.001), and the grade point average in the past year (b=-0.945, 95%ci; -1.197- -0.693, p= 0.001) had significant relationship with self-harm behaviors (r2= 0.145). moreover, gender (or=4.874, 95%ci; 2.297-10.344, p=0.001), grade point average in the past year (or=0.727, 95%ci; 0.567-0.932, p=0.012), substance abuse (or=7.972, 95%ci; 3.424-18.564, p=0.001), depression (or=1.163, 95%ci; 1.065-1.271, p=0.001), stress (or=1.105, 95%ci; 1.006-1.213, p=0.036), and father’s educational level (or=7.897, 95%ci; 1.138-54.807, p=0.001) had significant relationship with deliberate self-cutting.conclusion: self-harm behaviors in adolescents are associated with anxiety, depression, and stress.