Teenagers who identify as "goths", a subculture known for its members' black clothes and makeup, have a three times higher risk of depression than non-goth peers, researchers say.
But they could not be sure whether it was a case of depression leading kids to join this particular subgroup, or being caused by it.
"Our study does not show that being a goth causes depression or self-harm, but rather that some young goths are more vulnerable to developing these conditions," said the study's lead author Lucy Bowes from the University of Oxford.
In a years-long study of over 2,300 British teens, Bowes and a team found that 15-year-olds who identified very strongly with the goth subculture were three times more likely than their non-goth peers to be clinically depressed by age 18.
They were also five times more likely to physically harm themselves, the researchers reported in The Lancet Psychiatry.
At 15, the study participants were asked to what extent they identified with a variety of subcultures, including "sporty", "popular", "skaters", "loners", and "bimbos". Three years later, they were re-assessed for symptoms of depression and self-harm.
"Skaters" and "loners" also presented an increased risk, but not to the extent of goths, the researchers found.
"Young people who self-identified as 'sporty' were least likely to have depression or self-harm at age 18," said a statement.
It was possible, the team said, that "peer contagion" within the goth subculture was responsible for the link, but it could also be that the group attracted already depressed social outcasts.
"Teenagers who are susceptible to depression or with a tendency to self-harm may be attracted to the goth subculture which is known to embrace marginalised individuals," said co-author Rebecca Pearson from the University of Bristol in Britain.
Teenage goths should be closely monitored, the authors said, so that those at risk can be offered support.