Deliberate self-harm in young people: differences in prevalence and risk factors between the Netherlands and Belgium.

Background: This study aimed to examine prevalence and risk factors of deliberate self-harm in Dutch and Dutch-speaking Belgian adolescents.

Method: A cross sectional survey using an anonymous self report questionnaire was performed in both countries. Data on 4,431 Belgian and 4,458 Dutch 15-16 year-old school pupils were analyzed.

Results: Results showed a significant difference between the two countries indicating that lifetime and past year prevalence of deliberate self-harm were both 2.8 times higher in Belgian adolescents than in Dutch adolescents. Further analyses identified differences in the prevalence of factors associated with deliberate self-harm, with Belgian adolescents showing significant higher scores on anxiety, less problem-oriented coping and more common use of alcohol and soft drugs. Belgian adolescents were also at higher risk for the experience of several life events in the previous year and before that such as conflicts with peers, parents and partner, being bullied at school or exposure to suicidal behavior in family and friends. In addition, Belgian adolescents showed less communication with family or teachers about their problems and difficulties.

Conclusions: The results of the study suggest that the increased risk of deliberate self-harm among Belgian adolescents may be associated with an increased reporting of several important life events and with additional ineffective problem-solving such as less problem-oriented coping, more substance use and less communication about their problems. These results support the assumption that sociocultural aspects of nations can influence the risk of deliberate self-harm and are important to consider when developing prevention strategies.