Deliberate self-harm (and attempted suicide).

INTRODUCTION

The lifetime prevalence of deliberate self-harm is about 3-5% of the population in Europe and the USA, and has been increasing. Familial, biological, and psychosocial factors may contribute. Risks are higher in women and young adults, people who are socially isolated or deprived, and people with psychiatric or personality disorders.

METHODS AND OUTCOMES

We conducted a systematic review and aimed to answer the following clinical question: What are the effects of treatments for deliberate self-harm in adolescents and adults? We searched: Medline, Embase, The Cochrane Library, and other important databases up to October 2006 (Clinical Evidence reviews are updated periodically, please check our website for the most up-to-date version of this review). We included harms alerts from relevant organisations such as the US Food and Drug Administration (FDA) and the UK Medicines and Healthcare products Regulatory Agency (MHRA).

RESULTS

We found 19 systematic reviews, RCTs, or observational studies that met our inclusion criteria. We performed a GRADE evaluation of the quality of evidence for interventions.

CONCLUSIONS

In this systematic review we present information relating to the effectiveness and safety of the following interventions: cognitive therapy; continuity of care; dialectical behavioural therapy; emergency card; flupentixol depot injection; general practice-based guidelines; hospital admission; intensive outpatient follow-up plus outreach; mianserin; nurse-led case management; oral antipsychotics; paroxetine; problem-solving therapy; psychodynamic interpersonal therapy; and telephone contact.