Abstract
Self-harming behavior (SHB) is a conscious violation of physical integrity, without intent to die. This behavior occurs in up to 25-55 % of eating disordered patients.
It is maladaptive resolution of negative emotional feelings (depersonalization, dissociation, tension, anger ...). After the act of self-harm, up to one third of the patients feel worse, which is one of the reasons why self-harm is considered a risk factor for suicide.
The risk of SHB lies in addiction on this behavior, which is caused by endogenous opioid system. Another complication is "the phenomenon of imitation" - a tendency of non self-harming patients to adopt this behavior from the self-harming patients.
The therapy of this syndrome is complex - pharmacological and psychotherapeutical. The most commonly used medications are SSRI or augmentation with mood stabilizers or low doses of neuroleptics.
The most effective psychotherapy is cognitive behavioral therapy (CBT), concentrating on realizing the reasons for this behavior and finding alternative solutions.