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Chapter 5 - Self-Harm and Suicidal Thoughts

Published online by Cambridge University Press:  04 January 2024

By
Allan House
Edited by
Rachel Thomasson ,
Elspeth Guthrie  and
Allan House
Rachel Thomasson
Affiliation:
Manchester Centre for Clinical Neurosciences
Elspeth Guthrie
Affiliation:
Leeds Institute of Health Sciences
Allan House
Affiliation:
Leeds Institute of Health Sciences
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Summary

Lifetime prevalence of self-harm (self-poisoning or self-injury) is 5–6% in the UK adult population. Rates are increasing especially among young women, where lifetime prevalence is now 25%. The commonest immediate causes are social and interpersonal problems. The most commonly associated mental health problems are mood disorders and alcohol misuse. Assessment involves careful characterisation of the act of self-harm, the person who self-harms and their social circumstances, but should not entirely be focussed on risk. It should identify needs in mental health or physical health, social needs and psychological needs, and should be a therapeutic experience for the person who has self-harmed. The assessment itself may be helpful for some. Research into cost-effective treatment is limited, but even so it is reasonable to offer brief psychological therapies to everybody and longer-term therapies to those with severe repeated self-harm. Quality improvement activities should aim to improve the experience for people making contact with mental health and to increase the availability and accessibility of therapeutic interventions for self-harm.

Keywords

suicideself-harmcrisis plan
Type
Chapter
Information
Seminars in Consultation-Liaison Psychiatry , pp. 61 - 77
Publisher: Cambridge University Press
Print publication year: 2024

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References

National Institute for Health and Care Excellence. Self-harm in over 8s: Long term management. NICE Guideline. September 2022; NG 225.Google Scholar
Mumme, TA, Mildred, H, Knight, T. How do people stop non-suicidal self-injury? A systematic review. Arch Suicide Res. 2017;21(3):470–89.CrossRefGoogle ScholarPubMed
House, A, Kapur, N, Knipe, D. Thinking about suicidal thinking. The Lancet Psychiatry. 2020;7(11):997–1000.CrossRefGoogle ScholarPubMed
Clements, C, Turnbull, P, Hawton, K et al. Rates of self-harm presenting to general hospitals: A comparison of data from the Multicentre Study of Self-Harm in England and Hospital Episode Statistics. BMJ Open. 2016;6(2):e009749.CrossRefGoogle ScholarPubMed
Al-Sharifi, A, Krynicki, CR, Upthegrove, R. Self-harm and ethnicity: A systematic review. Int J Soc Psychiatry. 2015;61(6):600–12.CrossRefGoogle ScholarPubMed
Carroll, R, Metcalfe, C, Gunnell, D. Hospital presenting self-harm and risk of fatal and non-fatal repetition: Systematic review and meta-analysis. PLoS One. 2014;9(2):e89944.CrossRefGoogle ScholarPubMed
Hawton, K, Saunders, K, Topiwala, A, Haw, C. Psychiatric disorders in patients presenting to hospital following self-harm: A systematic review. J Affect Disord. 2013;151(3):821–30.CrossRefGoogle ScholarPubMed
O’Connor, RC, Nock, MK. The psychology of suicidal behaviour. The Lancet Psychiatry. 2014;1(1):73–85.CrossRefGoogle ScholarPubMed
Townsend, E, Ness, J, Waters, K et al. Self-harm and life problems: Findings from the Multicentre Study of Self-Harm in England. Soc Psychiatry Psychiatr Epidemiol. 2016;51(2):183–92.CrossRefGoogle ScholarPubMed
Suyemoto, K. The functions of self-mutilation. Clin Psychol Rev. 1998;18(5):531–54.CrossRefGoogle ScholarPubMed
Nock, MK, Prinstein, MJ. A functional approach to the assessment of self-mutilative behavior. J Consult Clin Psychol. 2004;72(5):885.CrossRefGoogle Scholar
Klonsky, ED. The functions of deliberate self-injury: A review of the evidence. Clin Psychol Rev. 2007;27(2):226–39.CrossRefGoogle ScholarPubMed
Edmondson, AJ, Brennan, CA, House, AO. Non-suicidal reasons for self-harm: A systematic review of self-reported accounts. J Affect Disord. 2016;191:109–17.CrossRefGoogle ScholarPubMed
Carroll, R, Metcalfe, C, Steeg, S et al. Psychosocial assessment of self-harm patients and risk of repeat presentation: An instrumental variable analysis using time of hospital presentation. PLoS One. 2016;11(2):e0149713.CrossRefGoogle ScholarPubMed
Hawton, K, Witt, KG, Taylor Salisbury, TL et al. Psychosocial interventions for self-harm in adults. Cochrane Database of Systematic Reviews. 2016(5).Google Scholar
Hetrick, SE, Robinson, J, Spittal, MJ, Carter, G. Effective psychological and psychosocial approaches to reduce repetition of self-harm: A systematic review, meta-analysis and meta-regression. BMJ Open. 2016;6(9):e011024.CrossRefGoogle ScholarPubMed

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