Deliberate self-harm (DSH) behaviors should be taken seriously by the psychiatrist. Comprehensive evaluation and treatment must be individualized for each patient, but here are important points to keep in mind when assessing and treating these difficult conditions.
TIPSHEET: SELF-HARM SIGNS AND BEHAVIORS
■ Methods of self-harm
• Cutting
• Poisoning
• Drug overdose
• Battery (hitting)
• Biting
• Shooting
• Burning
• Hanging
• Pinching
• Scratching
• Well jumping
• Jumping from bridges, buildings, or other high places
■ Deliberate self-harm etiological factors
• Overt depression
• Low self-esteem and sense of persistent hopelessness
• Impulsivity
• School influence of intimation (such as bullying)
• Family dysfunction and conflict
• Poverty
• Abuse
■ Keep these points in mind
• Nonsuicidal deliberate self-harm in adolescents reflects underlying hopelessness and low self-esteem as well as other factors that precipitate attempts to deal with unacceptable inner feelings and/or impact the behaviors of others, such as peers or family members.
• Early intervention may prevent or at least reduce chronic DSH behavior that if left untreated may become impervious to treatment.
• The key to successful interventions is the development of positive coping mechanisms, the reduction of relief underlying stress, and improvement in communication skills.
Note: Adapted from a 2011 article published in Psychiatric Times by Donald E. Greydanus, MD, titled "Treating Self-Harm in Children and Adolescents."
