Refers to an intentional act of self-poisoning or self-injury, irrespective of the motivation or apparent purpose of the act. It is an expression of emotional distress
Aetiology
Common methods of self harm include:
Hanging, strangulation, and suffocation
Poisoning (including overdose)
Risk factors
A wide range of psychiatric problems, such as borderline personality disorder, depression, bipolar disorder, schizophrenia, drug misuse and alcohol abuse are associated with self-harm
Other risk factors include victims of domestic violence, socio-economic disadvantage, and those with eating disorders
Pathophysiology
Self-harm promotes the release of endorphins
It brings temporary distress reduction, so through negative reinforcement these behaviours tend to be repeated
History of deliberate self-harm is the single strongest risk factor for suicide HOWEVER deliberate self-harm is not an attempt at suicide in the vast majority of cases
It is usually an attempt to maintain control in very stressful situations or emotional pressures
Management
Initial management includes e.g. activated charcoal for most drug overdoses
Assessment and further management involves risk assessment and the formation of a care plan
Psychological intervention that is structured for people who self-harm should be offered
Psychological, pharmacological and psychosocial interventions should be used for any associated mental health conditions
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