Deliberate self-harm in adolescents with OTC-related psychiatric disorders: A study of prevalence and associated factors.

Aim: This study examines the issues of over-the-counter (OTC) drug abuse among adolescents from the perspective of deliberate self-harm and suicide. It aims to elucidate the clinical characteristics of psychiatric disorders related to OTC drug use and explore treatment approaches in the context of self-harm and suicide prevention. Methods: The study analyzed 93 adolescent cases (ages 10-19) of 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." Cases were categorized into two groups based on the presence or absence of incidents of deliberate self-harm within the past year. Clinical variables were compared between the two groups. Results: Incidents of deliberate self-harm within the past year were observed in 82.8% of the cases. Clinical features significantly associated with deliberate self-harm included being female, having an educational level of high school dropout or lower (including current enrollment in middle or high school), and engaging in sub-threshold drug use not meeting the diagnostic criteria for addiction. Furthermore, recent OTC drug use, severity of substance use disorder, and the presence of comorbid psychiatric disorders were not associated with "deliberate self-harm" among adolescents with OTC-related psychiatric disorders. The use of existing medical or non-medical resources designed for drug addiction treatment was also not associated with self-harming behavior. Conclusion: From the standpoint of suicide and self-harm prevention, conventional approaches centered on substance use disorder treatment and recovery support may not be sufficiently effective for this population.