The primary aim of our study was to determine gender differences of the prevalence rates of suicidal behaviour (suicidal ideation, plans and attempts) and self-injurious behaviour (intentional self-mutilative acts like cutting and burning).

Self-report cross-sectional survey. A representative sample of school students of the 9th grade (n = 5759, mean age = 14.98 (SD=0.73), 49,8% female adolescents) from the Rhein-Neckar-District in Germany has been investigated.

Moderate forms of intentional self-mutilative acts in the previous year was reported by 630 of 5759 (10.9%) school students. Additional 229 (4.0%) students reported repetitive forms of self-mutilation. In comparison with the male students the risk of moderate forms of self-mutilative acts (relative risk ratio: RRR=1.60) was significantly increased for female students, for repetitive acts (RRR=2.64), respectively. With regard to suicidal behaviour 14.4% of the adolescents reported suicidal ideas and 7.9% one or more suicidal attempts during their life time. Adolescent girls who smoked demonstrated a high rate of risk for DSH; there was no significant association between smoking and DSH in adolescent boys. Compared with participants without a history of DSH, adolescents with DSH scored significantly higher on the YSR-subscales of somatic complaints, anxiety and depressive symptoms and delinquent behaviour.

Moderate forms of intentional self-mutilative acts and severe forms as well as suicidal behaviour were found to be associated with pronounced emotional and behavioral problems. In particular female adolescents are at higher risk for DSH in comparison to male adolescents.