title: Practitioner review: Self-harm in adolescents.
abstract: 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.
  
  
  OBJECTIVE
  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.
  
  
  METHODS
  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.
authors.affiliation: Child and Adolescent Psychiatry, King's College London, Institute of Psychiatry, De Crespigny Park, London, UK. dennis.ougrin@kcl.ac.uk
authors.forename: Dennis
authors.initials: D
authors.lastname: Ougrin
authors.forename: Troy
authors.initials: T
authors.lastname: Tranah
authors.forename: Eleanor
authors.initials: E
authors.lastname: Leigh
authors.forename: Lucy
authors.initials: L
authors.lastname: Taylor
authors.forename: Joan Rosenbaum
authors.initials: JR
authors.lastname: Asarnow
mesh_terms: D000293:Adolescent; D002648:Child; D015928:Cognitive Behavioral Therapy / Q000379:methods; D005196:Family Therapy / Q000379:methods; D006760:Hospitalization; D006801:Humans; D001523:Mental Disorders / Q000150:complications / Q000523:psychology / Q000628:therapy; D011615:Psychotherapy, Group / Q000379:methods; D016032:Randomized Controlled Trials as Topic; D012307:Risk Factors; D016728:Self-Injurious Behavior / Q000150:complications / Q000523:psychology / Q000628:therapy*; D013405:Suicide / Q000523:psychology; D016896:Treatment Outcome; D000092864:Suicide Prevention