DSM-III diagnoses & responses to the Beck Depression Inventory were examined in 71 consecutive admissions to an in-patient psychiatric crisis service following deliberate self-harm. Although 80% of the admitted patients were moderately or severely depressed according to Beck Depression Inventory scores, only 31% were diagnosed with a major depressive episode. While all of the self-harm patients may be viewed as experiencing severe subjective distress, only a minority were shown to suffer from DSM-III depressive illness. The high depression scores on the Beck Depression Inventory may be related to the patients’ extreme distress preceding the crisis admission & to the high prevalence of personality disorders in this group of patients. (39 refs.)