Deliberate self-harm

Abstract

Deliberate self-harm is a major problem in the UK, with about 150 presentations to general hospitals in England and Wales each year. Most of these involve overdoses. Much self-harm occurs in the community and does not present in hospital. Deliberate self-harm is more common in females than males, though the sex ratio has declined in recent years. Deliberate self-harm is more common in areas of socioeconomic deprivation and poor social integration. The most common problems are relationship difficulties and psychiatric disorders, particularly depression, alcohol and drug abuse, anxiety and eating disorders. Personality disorders are also common. The drugs used for self-poisoning tend to reflect availability, including prescribing patterns. Repetition is common after deliberate self-harm and there is a high risk of suicide, particularly during the first year. Management of deliberate self-harm patients must include a thorough assessment. There is limited evidence for the efficacy of psychosocial and pharmacological treatments following deliberate self-harm, but psychological therapies have been shown to have significant benefits, particularly in females.