![]() 10įamily factors (parent–child interaction, perceived support, expressed emotion, experience of abuse, parental conflict, and parental mental health) are important risk factors associated with self-harm in children and adolescents. 7, 8, 9 A recent large, retro-spective, registry-based matched cohort study (n=5678) showed lower long-term risk of self-harm in people receiving psychosocial treatments compared with those who did not, but numbers needed to treat were large. 7 Studies with strong family involvement and substantial treatment dose showed significant reductions in self-harm events. 6 A recent systematic review and meta-analysis of 19 randomised controlled trials with 2176 participants found a small overall effect of three specific interventions (dialectical behaviour therapy, mentalisation-based therapy, and cognitive behavioural therapy) on repetition of self-harm. 5Ī single effective intervention has not been identified. Non-fatal repetition occurs in 18% of people who self-harm, according to a recent large multicentre study in England. 2 Self-harm in adolescents has serious consequences, and those who self-harm have a four times greater risk of death from any cause and a ten times greater risk of suicide than the general population, 2, 3, 4 indicating potentially avoidably high burdens of life-years lost and family and peer distress. Self-harm in adolescents is a global public health problem, with 10% of adolescents self-reporting self-harm within the past year 1 and suicide the second commonest cause of death in young people aged 10–24 years, after road traffic accidents.
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