title: The identification and management of self-mutilating patients in primary care.
abstract: Self-mutilation has been described as a complex group of behaviors resulting in the deliberate destruction of body tissue without conscious suicidal intent. Clinical reports suggest that many adults who engage in self-destructive behavior have childhood histories of trauma and disrupted parental care. Painless cutting after a period of depersonalization, followed by relaxation and repersonalization after bleeding, is the typical pattern reported. Complications include social rejection and condemnation as a response both to the behavior or the resulting disfigurement. The most serious complication of self-mutilation is death as a direct result of damage inflicted on the body or from a drug overdose. Primary care providers are in an excellent position to identify and intervene in self-injurious behavior. Establishing a trusting relationship appears to be the most critical component of assessing and treating the client who self-mutilates. Psychotherapy and psychotropic medications, though not specific to self-mutilation, remain the most compelling treatment options.
authors.forename: S J
authors.initials: SJ
authors.lastname: Dallam
mesh_terms: D000293:Adolescent; D000328:Adult; D015984:Causality; D003131:Combined Modality Therapy; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D008297:Male; D009730:Nursing Assessment; D010353:Patient Education as Topic; D011613:Psychotherapy; D012649:Self Concept; D012652:Self Mutilation / Q000175:diagnosis* / Q000209:etiology / Q000523:psychology / Q000628:therapy*; D017367:Selective Serotonin Reuptake Inhibitors / Q000627:therapeutic use
chemical_list: D017367:Selective Serotonin Reuptake Inhibitors