Index1 Introduction 32 Types of self-harm 33 Risk factors 33.1 Childhood risk factors 33.2 Adult risk factors 33.3 Coexisting medical conditions 34 Complications 44.1 Medical complications 44.2 Emotional complications 44.3 Practical complications 45 Presentation and diagnosis 46 Prevention and management 56.1 Medical management 56.2 Therapeutic management 56.3 Psychiatric management 57 Conclusion 58 References 69 Help and support 61. Introduction Self-harm is a term that describes a variety of behaviors in which two critical elements are present: the damage is acute and the damage is intentional. Self-harm is generally an unhealthy effort to cope with overwhelming emotions, such as intense anger, rage, terror, or shame. Psychiatrists often make a distinction between attempted suicide and self-harm because these acts are often committed without suicidal intent. The damage caused is usually severe enough to leave a bruise, scar or other mark or cause health problems.2. Types of Self-Harm Self-harm includes, but is not limited to, cutting, burning, branding, overdosing, breaking bones, interfering with wound healing, scratching, biting, hair pulling (trichotillomania), and skin piercing. It can also include eating disorders, excessive alcohol and drug use, although these are disputed by some doctors.3. Risk Factors3.1 Risk Factors in Childhood Sexual Abuse Neglect Emotional Abuse Physical Abuse Loss or Separation Parental Mental Health Problems Parental Substance Abuse3.2 Risk Factors in Adults Rape or sexual abuse Psychiatric diagnoses Substance abuse Lack of emotional support Intense and distressing emotions3.3 Coexistence m...... middle of paper ......4] http://www.tuneinnotout. com/topics/mental-health/self-harm /?gclid=COaD47_H87sCFc3KtAodHwoA1w [accessed: 02/07/2014] http://news.bbc.co.uk/2/hi/uk_news/scotland/8476703.stm [ accessed: 02/07/2014] http: //www.sane.org.uk/how_you_can_help/self_harm [accessed: 02/07/2014] Hawton, K et al: Self-harm in adolescents: self-report survey in schools in Scotland, The British Journal of Psychiatry ( 2009) Royal College of Psychiatrists College Report CR 158: Self-harm, suicide and risk: helping people who self-harm (2010) Suicide and deliberate self-harm in young people (2005). Hawton, K. & James, A., BMJ, 330, p.891-894 How are adolescents who self-harm, or experience thoughts of self-harm, different in terms of help-seeking, communication and coping strategies? (2005). Evans, E., Hawton, K. & Rodham, K., Journal of Adolescent, 28, p.573-587