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Little is known about the long-term psychosocial outcomes associated with self-harm during adolescence. We aimed to determine whether adolescents who self-harm are at increased risk of adverse psychosocial outcomes in the fourth decade of life, using data from the Victorian Adolescent Health Cohort Study.

We recruited a stratified, random sample of 1943 adolescents from 44 schools across the state of Victoria, Australia. The study started on Aug 20, 1992, and finished on March 4, 2014. We obtained data relating to self-harm from questionnaires and telephone interviews at eight waves of follow-up, commencing at mean age 15·9 years (SD 0·5; waves 3–6 during adolescence, 6 months apart) and ending at mean age 35·1 years (SD 0·6; wave 10). The outcome measures at age 35 years were social disadvantage (divorced or separated, not in a relationship, not earning money, receipt of …