What is considered a significant risk factor for self-harm in patients with depression?

A history of previous attempts at self-harm is considered a significant risk factor for self-harm in patients with depression because it indicates a pattern of behavior that has previously manifested. Individuals who have engaged in self-harming behaviors in the past are at a higher risk of repeating those behaviors in the future, especially if underlying mental health issues, like depression, persist and remain untreated. The previous attempts may also suggest that the individual is experiencing a level of distress that leads them to resort to self-harm as a coping mechanism.

Additionally, while being fully compliant with medication and having a strong social support network are generally protective factors that can help prevent self-harm, they do not pose a risk in themselves. An increased level of energy could be misinterpreted; although it can be a sign of improvement in some patients, it can also indicate manic behavior in bipolar disorder or a sudden shift in mood that could lead to impulsivity, but it is not a direct risk factor for self-harm in the context of depression. A history of previous attempts stands out clearly as a direct reflection of risk and a need for closer monitoring and intervention.