Melatonin Linked to Reduced Risk of Self-Harm in Youth

Sleep disorders such as insomnia are common among young people, especially those with psychiatric conditions.

According to some estimates, around 17% of youth engage in self-harming behavior. There are currently few empirically-supported treatments for the condition in youth.

A recent meta-analysis suggests that treating the causes of self-harm may reduce its incidence. Some have thus suggested that treating sleep problems may reduce the incidence of self-harm.

In Sweden, melatonin is the most commonly prescribed drug for sleep disturbances in children and teenagers. Melatonin is a naturally-occurring hormone that helps maintain the normal sleep-wake cycle and other biological processes.

Understanding more about how melatonin affects self-harm in children and adolescents could inform treatment options for the behavior.

Recently, researchers examined the risk of self-harm and unintentional injuries before and after melatonin treatment in youth with and without psychiatric conditions.

They found that melatonin treatment was linked to lower levels of self-harm—especially in adolescent girls with depression and anxiety.

The study was published in the Journal of Child Psychology and Psychiatry.

For the study, the researchers analyzed public healthcare data from 25,575 youths in Sweden who began melatonin treatment between ages 6 and 18.

The children and adolescents were followed for a year prior to melatonin prescription and a year following. They began treatment at an average of age 13 years old, and most commonly initiated treatment in November. Treatment lasted for an average of 6.4 months.

The researchers found that 87.2% of melatonin users received at least one psychiatric diagnosis by age 18. Over 50% received an ADHD diagnosis. Self-harm was around five times more common in girls than boys.

In the end, the researchers found that melatonin use decreased the risk of self-harm by 42% and poisoning risk by 41%. Effects were especially prevalent among girls and adolescents with depression and or anxiety.

They noted, however, that melatonin use did not decrease rates of bodily injuries, falls, or transport accident rates.

Dr. Johnston-Arbor said whether taking melatonin regularly at a young age may speed the onset of puberty.

“In animal studies, melatonin administration was found to both speed up and delay the start of puberty, depending on the animal species. Melatonin administration may alter the brain’s production of hormones, including the gonadotropin-releasing hormone, which regulates puberty in humans,” she said.

“Melatonin may also alter the process of female reproductive organ development. However, multiple human studies involving children who were administered melatonin over prolonged periods of time have not shown adverse effects on puberty,” she added.

She said the findings “indicate that children with sleep disorders may experience additional benefits, other than sleep regulation, after the use of melatonin.”

“Additional studies are needed to determine whether the results of this study can be applied to other populations and to confirm the optimal dose and duration of use of melatonin needed to achieve the results found in this investigation”. 

Sources:

Fox, K. R., Huang, X., Guzmán, E. M., Funsch, K. M., Cha, C. B., Ribeiro, J. D., & Franklin, J. C. (2020). Interventions for suicide and self-injury: A meta-analysis of randomized controlled trials across nearly 50 years of research. Psychological Bulletin, 146(12), 1117–1145. https://doi.org/10.1037/bul0000305

Khazaie, H., Zakiei, A., McCall, W. V., Noori, K., Rostampour, M., Sadeghi Bahmani, D., & Brand, S. (2021). Relationship between Sleep Problems and Self-Injury: A Systematic Review. Behavioral sleep medicine, 19(5), 689–704. https://doi.org/10.1080/15402002.2020.1822360

Donna Gillies, Maria A. Christou, Andrew C. Dixon, et al. (2018) Prevalence and Characteristics of Self-Harm in Adolescents: Meta-Analyses of Community-Based Studies 1990–2015. American Academy of Child and Adolescent Psychiatry, VOLUME 57, ISSUE 10, P733-741 DOI: https://doi.org/10.1016/j.jaac.2018.06.018 

Leone, M., Kuja-Halkola, R., Lagerberg, T., Bjureberg, J., Butwicka, A., Chang, Z., Larsson, H., D’Onofrio, B.M., Leval, A. and Bergen, S.E. (2023), Melatonin use and the risk of self-harm and unintentional injuries in youths with and without psychiatric disorders. J Child Psychol Psychiatr. https://doi.org/10.1111/jcpp.13785 

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