Base de donn?es sur les mesures de qualit?

Désignent les personnes âgées de 12 à 19 ans.
Autres domain(es) : Patients souffrant des problèmes aigus, Psychothérapie

Children and young people who self-harm have a number of special needs, given their vulnerability. Physical treatments will follow similar principles as for adults.

For adolescents there is strong evidence suggesting that there is a clinically significant difference favouring group therapy over standard aftercare on reducing the likelihood of repetition, although the numbers were small. For other therapies and outcomes there is insufficient evidence of effectiveness. The evidence reviewed here suggests that there are surprisingly few specific interventions for people who have self-harmed that have any positive effect. The GDG came to the conclusion that, at the present time, there was insufficient evidence to support any recommendation for interventions specifically designed for people who self harm.

While there may be some evidence for the treatment of subgroups of service users, such as those diagnosed with borderline personality disorder, the studies were too small to make recommendations. However, the positive outcome for adolescents who have repeatedly self-harmed receiving group therapy is encouraging; although, because of the rather selective group this was applied to, this approach is in need of further investigation.

Moreover, the GDG came to the conclusion that referral for further treatment after an act of self-harm should be determined by the overall needs of the service user, rather than by the fact that they have self-harmed per se. This draws attention to the reliance on repetition as the primary outcome measure in many studies whereas outcomes relevant to service users such as depression status or quality of life may be more relevant.

The National Institute for Clinical Excellence. Self-harm. The short-term physical and psychological management and secondary prevention of self-harm in primary and secondary care. November 2004. P. 68, Section 4.9.1.13, P. 178, Section 9.9.1.6.
Retrieved on Aug 3, 2006 from: http://www.nice.org.uk/page.aspx?o=cg016niceguideline

II: Études démontrant les effets positifs de l?intervention. Certaines études sont moins rigoureuses et s?appliquent aux soins de première ligne en santé mentale; d?autres sont excellentes en soins de deuxième ligne, mais leurs les résultats sont appliqués aux soins de première ligne dans le présent sondage.

• *Première vs deuxième? Plutôt deuxième, je crois.
• *Je ne suis pas certain si les groupes de travail sont toujours « culturellement » appropriés.
• Préoccupation potentielle concernant la dynamique de groupe pour cette population, mais cela est davantage anecdotique et n'est pas fondé sur des résultats de recherche.

Rang selon les cotes Pertinence 97 Applicabilité 106 Importance générale 83		Rang selon les groupes d'acteurs Universitaires/chercheurs 96 Cliniciens 103 Usagers 101 Décideurs 89 ?		Rang selon les groupes particuliers Premières Nations 66 Régions rurales 90 Acteurs fédéraux 78
Rang selon les provinces et territoires CB AB SK MA ON QC NB NÉ IPE TN YU TNO NU 66 82 75 131 91 81 142 110 150 105 80 70 156				Rang global        97