Suicide and deliberate self-harm in children and adolescents

Rates of deliberate self-harm (DSH) in children and adolescents are rising. Only a small proportion of episodes result in presentation to hospital. Paediatricians have an important role to play in preventing DSH in community and non-psychiatric settings through maintaining up-to-date knowledge of risk factors and considering clinical issues such as intent, motives and psychosomatic presentations. Current treatment options including the ongoing controversies surrounding the use of selective serotonin reuptake inhibitors are outlined, along with factors that influence help-seeking and prevention.