DELIBERATE self-harm affected most adolescents with over-the-counter (OTC) related psychiatric disorders in a nationwide Japanese analysis.
Deliberate Self Harm Prevalence in OTC Related Disorders
Researchers examined over the counter drug use among adolescents from the perspective of deliberate self-harm and suicide prevention. The analysis included 93 cases aged 10 to 19 years with psychiatric disorders primarily attributed to OTC drug use, extracted from the 2024 Nationwide Survey on Drug Related Psychiatric Disorders in Psychiatric Medical Facilities in Japan. Adolescents were grouped by whether they had experienced deliberate self-harm in the past year, and clinical variables were compared between groups.
Deliberate self-harm within the past year was observed in 82.8% of cases, suggesting that self-harming behavior is pervasive in this clinical subgroup.
Factors Associated with Deliberate Self Harm
Deliberate self-harm was significantly associated with being female and with an educational level of high school dropout or lower, a category that also included adolescents currently enrolled in middle or high school. The study also found an association with subthreshold drug use that did not meet diagnostic criteria for addiction.
In contrast, several clinical measures were not associated with deliberate self-harm. Recent OTC drug use and substance use disorder severity were not linked to self-harming behavior. The presence of comorbid psychiatric disorders was also not associated, and the use of existing medical or nonmedical resources designed for addiction treatment was likewise not associated with self-harming behavior.
Implications for Care Pathways
The authors conclude that conventional approaches centered on substance use disorder treatment and recovery support may not be sufficiently effective for adolescents with OTC related psychiatric disorders when the goal is self-harm and suicide prevention. Clinically, the findings suggest that addiction severity markers alone may be inadequate for risk stratification in this population. Instead, care planning may need to foreground direct assessment of deliberate self-harm history alongside contextual factors such as schooling disruption and patterns of OTC drug use that fall short of addiction criteria.
Because the dataset was limited to cases identified in psychiatric medical facilities in Japan and the sample size was modest, the results should be interpreted cautiously and may not generalize across health systems. Even so, the very high prevalence reported underscores the need to integrate deliberate self-harm prevention into management pathways for adolescents presenting with OTC related psychiatric disorders.
Reference: Matsumoto T et al. Deliberate self-harm in adolescents with OTC-related psychiatric disorders: A study of prevalence and associated factors. PCN Rep. 2025;4(4):e70271.
