Evidence on managing deliberate self harm is limited

Deliberate self harm is a major health problem associated with considerable risk of subsequent self harm, including completed suicide. It is an important focus for suicide prevention. Hawton and colleagues (p 441) conducted a systematic review of the effectiveness of various treatments for such patients in terms of prevention of further suicidal behaviour. From the results of 20 randomised controlled trials they conclude that there is insufficient evidence to indicate the most effective care for this large population of patients. Promising results were found for problem solving therapy, provision of a card to allow emergency contact with services, depot flupenthixol for recurrent repeaters of self harm, and long term psychological therapy for women with borderline personality disorder and recurrent self harm. Inadequate numbers of patients, even when the results of individual trials were synthesised in meta-analyses, limit the conclusions that can be reached. Larger trials are badly needed.


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Relevant Article

Deliberate self harm: systematic review of efficacy of psychosocial and pharmacological treatments in preventing repetition
Keith Hawton, Ella Arensman, Ellen Townsend, Sandy Bremner, Eleanor Feldman, Robert Goldney, David Gunnell, Philip Hazell, Kees van Heeringen, Allan House, David Owens, Isaac Sakinofsky, and Lil Träskman-Bendz
BMJ 1998 317: 441-447. [Abstract] [Full Text] [PDF]

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