Deliberate self-harm and suicide in adolescents.Keio J Med 2009; 58(3):144-51KJ
Deliberate self-harm (DSH) is a widespread yet often hidden problem in adolescents and young adults. Though most DSH can be classified as "non-suicidal self-cutting", some do go on to commit suicide. In this paper, deliberate self-harm is examined, including its prevalence, etiology, management, and future research directions using self-cutting and self-burning as examples. This article reviews recent literature to help understand what is known about self-cutting behavior and its potential relationship to suicide as well as provide direction for research. Research shows that different ecological factors at the individual, family, peer, and societal levels are related to deliberate self-harm. Although there is an association between some self-injurers and drug abuse (including alcohol abuse) as well as eating disorders, there are various subgroups of self-cutters and most are not at high risk for suicide. However, all acts of self-injury should be taken seriously by health care professionals and comprehensive therapy offered to any adolescent with a history of DSH. Future research directions on deliberate self-harm are also discussed.