Few studies have focused on the persistence of nonsuicidal self-injury (NSSI) over time in developmental age. This study aimed to define the psycho-behavioral profiles of young inpatients according to past or recent NSSI onset (i.e., NSSI for more or less than one year, respectively), and identify possible risk factors for maintaining NSSI over time. A total of 118 Italian NSSI inpatients aged 9–17 were involved. The Youth Self-Report (YSR) was administered. K-means cluster analyses were conducted using the YSR affective disorders, social competencies, and social problems scales as clustering variables. A binomial logistic regression was run to clarify which of these variables discriminate between the past and recent NSSI onset groups. Chi-square tests were performed to pinpoint the variables associated with long-standing NSSI. The final cluster solution displayed four psycho-behavioral profiles; a greater number of inpatients with recent NSSI onset was found in the clusters characterized by scarce social competencies. Affective disorders and social competencies were significant predictors, and higher scores on both scales were more likely in the past NSSI onset group. School problems and alcohol/substance use were related to long-standing NSSI. Therefore, a lack of social skills may be involved in recent NSSI onset, while affective disorders and other problem behaviors may dictate the continuation of NSSI over time.