Teens identifying with the "goth" culture may be more vulnerable to depression and self-harm, according to a UK study.

More than a third of goth teens reported hurting themselves on purpose and nearly a fifth reported being depressed - rates that were around three times higher than among other teens, which suggests that gravitating to the goth lifestyle could be a sign of a teen at risk, researchers said.

"The subcultures that young people identify with has not been studied very much in relation to psychiatric outcomes," said lead author Lucy Bowes, a research fellow at the University of Oxford in England.

Bowes and her colleagues wanted to see if there was a link between the goth subculture and depression and whether it might be explained by other factors in the teens' lives.

Rates of depression increase greatly during the teen years, and it is important to understand risk factors in order to figure out the best treatment, the study team writes in The Lancet Psychiatry, online August 27.

According to the Oxford English Dictionary, a goth is "a member of a subculture favouring black clothing, white and black make-up, and goth music," the study team notes. However, they write, there is plenty of variation, and in general, many social norms are associated with being a goth, including alternative clothing and music, and a dark, morbid mood and aesthetic.

The researchers used data on 3,694 children born in the UK in 1991 and 1992, who were participating in a study that followed them through age 18 years.

The children visited a research clinic every year after age seven, where they and their parents provided information on the child's emotional state, experience with bullying and the mother's history of depression.

When the participants reached 15 years old, they answered questions about which social groups and subcultures among their peers they identified with, and indicated if that identification was "very much" or "somewhat."

When the participants turned 18, the researchers measured the teens' rates of depression and self-harm, such as taking an overdose of pills or self-cutting.

The study team found that teens who identified as goth were more likely to be girls and to have mothers with a history of depression. They were also more likely to have been bullied at ages 8 and 10 and to have a history of emotional and behavioral difficulties, as rated by their mothers.

When assessing teens' risk of depression and self-harm, the researchers adjusted for these factors.

Of the 1,841 teens who did not identify as Goths at age 15, about 6% met the criteria for depression at age 18. Among the 154 teens who identified very much as goths, 18% were depressed at age 18.

About 10% of non-goth teens reported self-harm, compared with 37% of goth teens.

Bowes said that young people who are more susceptible to depression may be more attracted to a subculture like the goth culture that tends to be accepting of marginalized groups.

Peer influence may also play a role, she noted. "When vulnerable youths are exposed to other vulnerable youths who are already self-harming, it might increase their own likelihood of going on to self-harm."

In Dr. Paul Plener's own research, "adolescents belonging to an alternative youth culture stated feeling as part of a group as a motive for self harm," he told Reuters Health by email.

Despite this peer influence, goth culture itself is not necessarily problematic and can foster close relationships, said Plener, who is deputy medical director of child and adolescent psychiatry and psychotherapy at the University of Ulm in Germany and was not involved in the UK study.

Bowes noted that these friendships can be important support and validation for young people, particularly those experiencing bullying.

Parents of goth teens should not try to discourage teens from seeing their friends, Bowes said. Instead, she said, "we should try to reduce stigma targeted at different subcultures in our societies, as well as providing support and information for young people who are more vulnerable to depression and self-harm."