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A sizable amount of adolescents do self-harm, but most cases do not reach medical services as well as the attention of college administration and parents, making such a study essential to be carried out. The prevalence of suicidal thoughts and deliberate self-harm behavior remains largely unexplored. In this study, self-harm behaviors among adolescents studying at higher secondary schools were evaluated in selected schools of Kathmandu Valley in Nepal. Methods: The purposive sampling of five different higher secondary schools in the Kathmandu valley were taken as a study area and the census was done to select the sample population of the selected higher secondary school. A crosssectional analysis of self-administered questionnaire data was collected aftertaking informed and assent consent from participants (n= 243)14-19 years old. Results: The prevalence of lifetime self-harm was approximately 55.6%. The most commonly used self-harm method was scratching the skin intensely (14.5%) and was followed by carving words or other marks on the skin (14.0%). Of those who reported self-harm, 34.8%, intentionally hurt themselves to get the attention of others and 17.8% to punish themselves. Concurrent alcohol consumption (OR=3.660), cigarette smoking (OR=2.50), and depression (OR= 3.01) were associated with a significantly increased risk of self-harm. Similarly, problems with various social relationships were associated with the risk of self-harm. 68.1% knew other people harming themselves before they were involved in self-harm and 19.6% were influenced by family, friends, and media to harm themselves. Conclusions: Self-harm behaviors are common among adolescents. Although the majority of self-harm behavior is not accompanied by a desire to die (serious attempt), all self-harm regardless of motivation is associated with an increased risk of deliberately harming when it is carried out repeatedly.

Self-Harm Behavior among Adolescent Students of Higher Secondary Schools of Kathmandu Valley, Nepal