Deliberate self-harm in adolescence and family dysfunction: case report

Abstract

Introduction: Deliberate self-harm (DSH) has a significant prevalence among young people. It is a sign of disturbed adolescence. There are multiple risk factors, including family dysfunction and parental mental illness. This case report shows how the family doctor, with good accessibility and communication with other health resources, can guide the patient and the family in situations of DSH and family dysfunction. Case description: NV, a 12 year-old male, was brought to our clinic after an episode of self-harm (cutting his forearms with scissors), irritability, impulsivity, and verbal aggression, following aggressive behavior by his father. The family doctor referred the boy to a child psychiatry emergency service. A second appointment was scheduled to ensure adequate follow-up together with secondary care. Family dysfunction was diagnosed with repercussions for adolescent development. Several family members received treatment. The adolescent agreed to frequent child psychiatry and psychology consultations, with improvement in symptoms. Commentary: The family doctor plays an essential role in the early detection and referral of cases of DSH. In this case, opportunistic intervention, when the adolescent first sought help, shows the importance of accessibility and the systemic family approach.