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Practitioner Review: Self-harm in adolescents.
MedLine Citation:
PMID:  22329807     Owner:  NLM     Status:  In-Data-Review    
Background:  Repeated self-harm in adolescents is common and associated with elevated psychopathology, risk of suicide, and demand for clinical services. Despite recent advances in the understanding and treatment of self-harm there have been few systematic reviews of the topic. Aims:  The main aim of this article is to review randomised controlled trials (RCTs) reporting efficacy of specific pharmacological, social or psychological therapeutic interventions (TIs) in reducing self-harm repetition in adolescents presenting with self-harm. Method:  Data sources were identified by searching Medline, PsychINFO, EMBASE, and PubMed from the first available year to December 2010. RCTs comparing specific TIs versus treatment as usual or placebo in adolescents presenting with self-harm were included. Results:  Fourteen RCTs reported efficacy of psychological and social TIs in adolescents presenting with self-harm. No independently replicated RCTs have been identified reporting efficacy of TIs in self-harm reduction. Developmental Group Psychotherapy versus treatment as usual was associated with a reduction in repeated self-harm, however, this was not replicated in subsequent studies. Multisystemic Therapy (MST) versus psychiatric hospitalisation was associated with a reduction of suicidal attempts in a sample of adolescents with a range of psychiatric emergencies. However, analyses focusing only on the smaller subgroup of adolescents presenting with deliberate self-harm at the initial psychiatric emergency, did not indicate significant benefits of MST versus hospitalisation. Conclusions:  Further research is urgently needed to develop TIs for treating self-harm in adolescents. MST has shown promise but needs to be evaluated in a sample of adolescents with self-harm; dialectic behavioural therapy and cognitive behavioural therapy for self-harm require RCTs to evaluate efficacy and effectiveness.
Dennis Ougrin; Troy Tranah; Eleanor Leigh; Lucy Taylor; Joan Rosenbaum Asarnow
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Journal of child psychology and psychiatry, and allied disciplines     Volume:  53     ISSN:  1469-7610     ISO Abbreviation:  J Child Psychol Psychiatry     Publication Date:  2012 Apr 
Date Detail:
Created Date:  2012-02-14     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0375361     Medline TA:  J Child Psychol Psychiatry     Country:  England    
Other Details:
Languages:  eng     Pagination:  337-50     Citation Subset:  IM    
Copyright Information:
© 2012 The Authors. Journal of Child Psychology and Psychiatry © 2012 Association for Child and Adolescent Mental Health.
Child and Adolescent Psychiatry, King's College London, Institute of Psychiatry, De Crespigny Park, London South London and Maudsley NHS Foundation Trust, Michael Rutter Centre, De Crespigny Park, London University of California, Los Angeles, CA, USA.
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