Recurrent self-harm

Self-harm is defined as an act with a non-fatal outcome in which an individual deliberately initiates behaviour, such as self-cutting or ingesting a substance, with the intention of causing harm to himself or herself. It is a significant public health problem across the lifespan, is the leading predictor of suicide, and is associated with substantial costs to both individuals and wider society. Psychological treatments such as dialectical behaviour therapy and mentalization-based treatment have shown the most promising results for reducing recurrent self-harm among subgroups of people with borderline personality disorder who self-harm. Currently, there is no evidence to support the use of pharmacological treatment in the management of self-harm, and some classes of antidepressants may actually be associated with an increased risk of self-harm, although more research is required in order to clarify this issue. Larger trials of both psychological and pharmacological treatments are needed as a matter of urgency.