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

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

[Article in German]

Author information

1 Klinik für Psychiatrie und Psychotherapie des Kindes- und Jugendalters, Zentralinstitut für Seelische Gesundheit, Mannheim.
2 Klinik für Kinder- und Jugendpsychiatrie und Psychotherapie, Universität Ulm.
3 Klinik für Kinder- und Jugendpsychiatrie, Zentrum für Psychosoziale Medizin, Universität Heidelberg.
4 Klinik für Psychoanalyse und Psychotherapie, Medizinische Universität Wien.
5 Klinische Psychologie und Psychotherapie des Kindes- und Jugendalters, Universität Koblenz-Landau.
6 Klinik für Kinder- und Jugendpsychiatrie, Psychosomatik und Psychotherapie, Universitätsklinikum Marburg und Philipps-Universität Marburg.



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.


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.


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.


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.


nonsuicidal self-injury; NSSI; self-harm; adolescents; guideline; therapy


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