[Nonsuicidal self-injury in adolescence: a clinical guideline for diagnostics and therapy]

Z Kinder Jugendpsychiatr Psychother. 2017 Nov;45(6):463-474. doi: 10.1024/1422-4917/a000463. Epub 2016 Sep 26.
[Article in German]


Objective: Nonsuicidal self-injury (NSSI) is a frequent, clinically relevant phenomenon occurring in adolescence, which can be observed parallel to various mental disorders. Within Europe, Germany has one of the highest prevalence rates in youths, with the lifetime prevalence ranging between 25–35 %. To date a guideline on the treatment of self-injury and stereotypic motoric disorders has been available, the last having been updated in 2006 and expired in 2011.

Methods: The guideline development group consisted of members of 11 medical, psychological, or psychotherapeutic professional associations and two members from patient and prevention groups. The guideline was developed in two meetings followed up by consecutive literature searches; it was adopted in a final consensus conference. The algorithm on the treatment of NSSI was approved in three rounds of a Delphi process.

Results: Although there is solid evidence of NSSI from the fields of epidemiology and diagnostics, few studies report data on the longitudinal course as well as on the psychotherapeutic and adjuvant psychopharmacological treatment of NSSI in adolescence. The stepped care regimens in cases demanding somatic treatment were addressed interdisciplinarily.

Conclusions: In accordance with the heterogeneous evidence, important points for the treatment of NSSI in adolescence were determined in a consensus conference. There is still a lack of knowledge on prevention as well as clinical interventions, both of which need to be addressed by further research.

Keywords: nonsuicidal self-injury; NSSI; self-harm; adolescents; guideline; therapy.

Publication types

  • Consensus Development Conference
  • Practice Guideline

MeSH terms

  • Adolescent
  • Algorithms
  • Combined Modality Therapy
  • Comorbidity
  • Cross-Sectional Studies
  • Female
  • Germany
  • Humans
  • Interdisciplinary Communication
  • Intersectoral Collaboration
  • Male
  • Mental Disorders / diagnosis
  • Mental Disorders / psychology
  • Mental Disorders / therapy
  • Self-Injurious Behavior / diagnosis*
  • Self-Injurious Behavior / epidemiology
  • Self-Injurious Behavior / psychology
  • Self-Injurious Behavior / therapy*