Conventional wisdom has viewed suicidal behavior as much more ominous than nonsuicidal self-injury. The thoughtful and clearly written article in this issue by Wilkinson and colleagues (1) from the Adolescent Depression Antidepressants and Psychotherapy Trial (ADAPT) should make us view nonsuicidal self-injury more seriously, as it was a stronger predictor of future suicidal behavior than was a previous history of a suicide attempt. While this may be surprising, it is not an isolated finding.
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