Summary of Published Self-Injury Interventions and Respective Levels of Evidence
| Intervention | Level of Evidence | SORT Rating | RCTs | Treatment Description | Patients Treated in Published Reports or RCTs (n) | Effect on Self-Injury |
|---|---|---|---|---|---|---|
| Topiramate | 3 | C | N/A | 200 mg/day | 3 | Cessation of self-injury |
| Clozapine | 3 | C | N/A | 300 to 550 mg/day for 4 to 12 months | 8 | Cessation of self-injury |
| Naltrexone | 3 | C | N/A | 50 mg/day | 8 | Cessation of self-injury |
| Dialectical behavior therapy | 1 | B | 3 | 12-month outpatient program; weekly individual modified cognitive-behavioral therapy; weekly skills training; ongoing skills coaching between sessions | 188 | Significant reduction of self-injury in 2/3 RCTs compared with TAU group |
| Manual-assisted cognitive behavior therapy | 3 | C | 2 | 2–7 individual cognitive therapy-oriented sessions; 70-page self-help book | 512 | No effect on self-injury |
| Transference-focused psychotherapy | 2 | C | 2 | 12-month outpatient program; weekly individual psychodynamic therapy | 23 | No effect on self-injury |
| Mentalization-based therapy | 2 | C | 0 | 18-month inpatient program; weekly individual psychodynamic therapy; weekly group psychodynamic therapy (3×); weekly individual psychodrama session | 19 | Significantly lower proportion of self-injurers compared with TAU group |
The number of patients is from randomized controlled trials only when available or from available, published, nonrandomized studies if no randomized controlled trials have been conducted.
SORT, strength of recommendation taxonomy; RCTs, randomized placebo-controlled trials; TAU, treatment as usual.