Pharmacological and Non-Pharmacological Interventions for Non-Suicidal Self-Injury: A Narrative Review

Non-suicidal self-injury (NSSI), particularly among youth, is an increasing, global, public health concern. Some studies have shown that NSSI is an independent risk factor for suicidal behavior. However, evidence-based treatment guidelines remain underdeveloped. We searched PubMed, Web of Science, and the China National Knowledge Infrastructure (CNKI) for studies on adolescent or adult NSSI published between January 2005 and August 2025 to try to determine the most effective treatment strategies. We included 50 studies. Interventions were categorized into psychotherapy, pharmacotherapy, neuromodulation, and digital health approaches. Psychotherapy, especially dialectical behavior therapy (DBT), showed the most consistent efficacy in reducing NSSI frequency and improving emotion regulation. Adjunctive pharmacotherapy with antidepressants and atypical antipsychotics alleviated comorbid symptoms, but caution is warranted in younger patients due to potential risks. Neuromodulation techniques, including repetitive transcranial magnetic stimulation (rTMS) and transcranial electrical stimulation (TES), may reduce NSSI through modulation of prefrontal cortex activity, and deep brain stimulation (DBS) show promise for treatment-resistant cases. Digital tools such as mobile applications, ecological momentary assessment, and artificial intelligence (AI)-assisted technologies enable real-time monitoring and risk prediction but remain complementary to traditional crisis intervention. Ultimately, in this review, we highlight the importance of multimodal and individualized strategies in managing NSSI and provide insights to guide future clinical practice and research.