title: Self-injurious behavior in the elderly.
abstract: OBJECTIVE
  To review the literature for self-injurious behavior (SIB) in the elderly and compare it with SIB in other populations.
  
  
  METHODS
  Literature searches were conducted using MEDLINE/PubMed, Merck-Medicus, clinicaltrials.gov, OVID, and an Internet search for "self-injurious behavior, SIB, and self-mutilation."
  
  
  METHODS
  Sixteen studies were reviewed. Studies used provided data relative to SIB in general or treatment for the geriatric population.
  
  
  RESULTS
  The data suggest that young children, adolescents, young adults, and developmentally disabled patients most commonly exhibit self-injurious behaviors. The elderly population, in particular those with certain psychiatric and neurodegenerative illnesses, also can exhibit these behaviors. There has been little published for this cohort in comparison with other populations. The authors reviewed the literature for papers on SIB and its management in the elderly. A general overview of SIB is provided, including specific factors for the elderly. Management strategies including pharmacological and behavioral interventions are also discussed.
  
  
  CONCLUSIONS
  Although the prevalence of SIB appears to be relatively small, patients who do exhibit this behavior are of great concern to their families and caregivers. Risk factors such as dementia, depressive disorders, physical illness, and loss of a spouse, which are commonplace in the elderly, all may contribute to those who do exhibit SIB. The literature is devoid of specific drug therapies or treatments that demonstrate significant efficacy in patients with SIB, particularly the elderly. Additionally, while there is some understanding of why younger people engage in SIB, it is hypothesized that elderly SIB is different and is related to frustration, as well as to deficits in the ability to communicate effectively with others. Recognition of behavioral triggers, behavioral-care planning, and safety management are key.
authors.affiliation: Neuropsychology Fellowship Program, McLean Hospital, Belmont, and Department of Psychiatry, Harvard Medical School, Boston, MA 02131, USA. smf@icpsgroup.com
authors.forename: Susan M
authors.initials: SM
authors.lastname: Parks
authors.forename: Stephen M
authors.initials: SM
authors.lastname: Feldman
mesh_terms: D000368:Aged; D014150:Antipsychotic Agents / Q000627:therapeutic use; D006801:Humans; D009292:Narcotic Antagonists / Q000627:therapeutic use; D011613:Psychotherapy; D016728:Self-Injurious Behavior / Q000209:etiology / Q000523:psychology / Q000628:therapy; D018490:Serotonin Agents / Q000627:therapeutic use
chemical_list: D014150:Antipsychotic Agents; D009292:Narcotic Antagonists; D018490:Serotonin Agents