Methods of Deliberate Self-harm in A Sample of Depressed and Non-depressed Egyptian Adolescents: Cross-sectional Study.

Background: Deliberate self-harm (DSH) is common among adolescents with depression and represents a significant clinical and toxicological concern due to associated injury- and exposure-related behaviors. Data on specific self-harm methods among Egyptian adolescents remain limited. Aim of the work: To compare DSH methods between depressed and non-depressed Egyptian adolescents and examine the association between depression severity and self-harm patterns. Patients and methods: This cross-sectional study included 55 adolescents with major depressive disorder and 55 healthy controls. Depression severity was assessed using the Children’s Depression Inventory, and self-harm behaviors were evaluated using the Deliberate Self-Harm Inventory. Results: Depressed adolescents showed significantly higher self-harm prevalence (58.2% vs. 30.9%, p=0.004) and greater method diversity (1.0, p<0.001) compared to controls. The most frequent behaviors included cutting, skin scratching, intentional superficial skin marking, and head-banging, all of which were significantly more common in the depressed group and are associated with potential medical and toxicological complications. A significant dose–response relationship was observed between depression severity and the number of self-harm methods used. Conclusion: Depressed Egyptian adolescents exhibit higher rates and greater complexity of self-harm behaviors, with increasing diversity as depression severity worsens. These findings underscore the importance of early identification and integrated psychiatric and toxicological assessment in adolescents engaging in self-harm.