@article{ref1,
title="Self-harm",
journal="Medicine (Abingdon)",
year="2020",
author="Butler, J.A.",
volume="48",
number="12",
pages="769-773",
abstract="Self-harm is one of the most common reasons for presentation to hospital. It is a reflection of distress rather than a diagnosis in itself. This article focuses on the management of people presenting to hospital with behaviour attributed to intent to harm themselves. Self-harm is associated with a significantly increased risk of future suicide, around 10% dying by suicide within 10 years, the risk being greatest in the first month. The National Institute for Health and Care Excellence quality standards and guidelines for the short-term management of self-harm make recommendations relevant to all healthcare professionals, emphasizing the importance of parallel psychosocial and physical management and assessment of the risk of further self-harm or suicide. Observation levels and discharge plans are also important. Current mental illness is a major risk factor for suicide, as are high intent of suicide at the time of the self-harm, a history of self-harm, current physical illness, poor social support and demographic variables. Risk of further self-harm is also higher in certain groups, including individuals who are middle-aged or elderly, have substance misuse or frequently self-harm. There are several standardized tools to aid risk assessment but none has adequate sensitivity and specificity to replace clinical judgement. © 2020<p /><p>Language: en</p>",
language="en",
issn="1357-3039",
doi="10.1016/j.mpmed.2020.09.017",
url="http://dx.doi.org/10.1016/j.mpmed.2020.09.017"
}