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Übersichtsarbeit

Nicht-suizidales selbstverletzendes Verhalten (NSSV) im Jugendalter: Klinische Leitlinie zur Diagnostik und Therapie

Published Online:September 23, 2016https://doi.org/10.1024/1422-4917/a000463

Abstract

Zusammenfassung.Hintergrund: Nicht-suizidales selbstverletzendes Verhalten (NSSV) ist ein häufiges, klinisch relevantes Phänomen im Jugendalter, das sich in Zusammenhang mit verschiedenen psychischen Störungen beobachten lässt. Deutschland gehört mit einer Lebenszeitprävalenz von 25–35 % bei Jugendlichen innerhalb Europas zu den Ländern mit den höchsten Prävalenzraten an NSSV. Bislang existierte eine zuletzt im Jahr 2006 überarbeitete AWMF-Leitlinie zu selbstverletzendem Verhalten und stereotypen Bewegungsstörungen, deren Gültigkeit 2011 abgelaufen war.

Methoden: Die Leitliniengruppe setzte sich aus elf medizinisch, psychologisch bzw. psychotherapeutischen Fachgesellschaften und zwei Interessensvertretungen aus Angehörigen- bzw. Präventionsprojekten zusammen. Die Leitlinie wurde in zwei Konferenzen, darauf aufbauenden Literaturrecherchen und einer abschließenden Konsensuskonferenz erarbeitet. Der Algorithmus wurde in drei Delphi-Runden verabschiedet.

Ergebnisse: Während die Datenlage zur Epidemiologie und zur Diagnostik von NSSV gut ist, sind noch immer wenige Studien zum Langzeitverlauf und zur psychotherapeutischen sowie zum Stellenwert einer psychopharmakologischen, adjuvanten Behandlung von NSSV im Jugendalter verfügbar. Berufsgruppenübergreifend wurde auch das Vorgehen im Falle der Notwendigkeit einer somatischen Versorgung bei NSSV thematisiert.

Schlussfolgerungen: In Anbetracht der heterogenen Evidenzlage wurden, um die klinische Anwendbarkeit der Leitlinie zu gewährleisten, die wesentlichen Punkte zur Behandlung von NSSV im Jugendalter in einer Konsensuskonferenz abgestimmt. Forschungsdefizite zeigen sich sowohl im Bereich präventiver als auch klinischer Interventionen.


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

Abstract.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

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