Interventions for self-harm in children and adolescents

Area of Science:

• Child and Adolescent Psychiatry
• Clinical Psychology
• Public Health

Background:

• Self-harm (SH) is prevalent in children and adolescents, frequently repeated, and strongly linked to suicide.
• This review focuses on psychosocial and pharmacological interventions for SH in this age group, updating previous broader reviews.
• The study addresses the critical need for effective treatments for adolescent self-harm.

Purpose of the Study:

• To identify and analyze randomized controlled trials (RCTs) of psychosocial and pharmacological interventions for self-harm in children and adolescents.
• To conduct meta-analyses where possible to compare treatment effects against control groups (e.g., treatment as usual, placebo).
• To evaluate the efficacy of specific interventions for reducing the repetition of self-harm.

Main Methods:

• Searched the Cochrane Depression, Anxiety and Neurosis Group (CCDAN) Specialised Register for relevant RCTs.
• Included RCTs comparing psychosocial or pharmacological treatments with control conditions in adolescents (up to 18 years) with recent SH.
• Extracted data and appraised study quality; performed meta-analyses for dialectical behavior therapy for adolescents and group-based psychotherapy using random-effects models.

Main Results:

• Eleven trials with 1,126 participants were included; all focused on psychosocial interventions.
• Mentalisation therapy showed potential in reducing self-harm repetition (moderate quality evidence).
• Dialectical behaviour therapy for adolescents (DBT-A) and group-based psychotherapy showed limited effectiveness or inconclusive results (low to very low quality evidence).

Conclusions:

• There is a paucity of high-quality evidence for effective interventions for adolescent self-harm.
• Therapeutic assessment, mentalisation therapy, and DBT-A warrant further investigation.
• Larger-scale trials with diverse outcome measures and patient collaboration are essential for developing effective interventions.