Deliberate self-harm (and attempted suicide)

The lifetime prevalence of deliberate self-harm is about 3% to 5% of the population in Europe and the US, 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.

We conducted a systematic review and aimed to answer the following clinical question: What are the effects of non-pharmacological treatments for deliberate self-harm in adolescents and adults? We searched: Medline, Embase, The Cochrane Library, and other important databases up to August 2013 (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).

Twenty-two studies were included. We performed a GRADE evaluation of the quality of evidence for interventions.

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; hospital admission; intensive outpatient follow-up plus outreach; nurse-led case management; problem-solving therapy; psychodynamic interpersonal therapy; and telephone contact.