Precipitating factors: Deliberate self-harm is fre-
quently precipitated by stressful life problems;
often these are interpersonal conflicts or difficul-
ties with parents or siblings, such as arguments, or
rejection by boy/girlfriends or peers, and school
problems such as academic difficulty and bullying.
It is frequently an impulsive act, with many individ-
uals thinking about it for just minutes before acting.
Over 50% consult their GP in the month before
190
Adolescence deliberate self-harm but presentation is generally
not with psychological symptoms [27].