Bibliographic Collection: 
MOCA Reference, APE
Publication Type: Journal Article
Authors: Skegg, K.
Year of Publication: 2005
Journal: Lancet
Volume: 366
Issue: 9495
Pagination: 1471-83
Date Published: 10/2005
Publication Language: eng
ISSN: 1474-547X
Keywords: Adolescent, Adult, Family, Female, Homosexuality, Humans, Male, Mental Disorders, Risk Factors, Self-Injurious Behavior, Social Class, Social Support, Suicide, Attempted

The term self-harm is commonly used to describe a wide range of behaviours and intentions including attempted hanging, impulsive self-poisoning, and superficial cutting in response to intolerable tension. As with suicide, rates of self-harm vary greatly between countries. 5-9% of adolescents in western countries report having self-harmed within the previous year. Risk factors include socioeconomic disadvantage, and psychiatric illness--particularly depression, substance abuse, and anxiety disorders. Cultural aspects of some societies may protect against suicide and self-harm and explain some of the international variation in rates of these events. Risk of repetition of self-harm and of later suicide is high. More than 5% of people who have been seen at a hospital after self-harm will have committed suicide within 9 years. Assessment after self-harm includes careful consideration of the patient's intent and beliefs about the lethality of the method used. Strong suicidal intent, high lethality, precautions against being discovered, and psychiatric illness are indicators of high suicide risk. Management after self-harm includes forming a trusting relationship with the patient, jointly identifying problems, ensuring support is available in a crisis, and treating psychiatric illness vigorously. Family and friends may also provide support. Large-scale studies of treatments for specific subgroups of people who self-harm might help to identify more effective treatments than are currently available. Although risk factors for self-harm are well established, aspects that protect people from engaging in self-harm need to be further explored.

DOI: 10.1016/S0140-6736(05)67600-3
Alternate Journal: Lancet
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