TY - JOUR PY - 2020// TI - Self-harm JO - Medicine (Abingdon) A1 - Butler, J.A. SP - 769 EP - 773 VL - 48 IS - 12 N2 - 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

Language: en

LA - en SN - 1357-3039 UR - http://dx.doi.org/10.1016/j.mpmed.2020.09.017 ID - ref1 ER -