title: Self-injurious behavior in the nursing home setting.
abstract: BACKGROUND
  Self-injurious behavior (SIB) in older adults is defined as harm inflicted on oneself without conscious suicidal intent. SIB as a separate entity distinct from suicidal intent is poorly understood. However, it is of great concern to the patients' families and caregivers and it poses serious clinical challenges for clinicians.
  
  
  METHODS
  We searched the database of PubMed, Ovid Medline, and ScienceDirect for reports published between 1970 and 2009 using combination of the following keywords: "self-injurious behavior", "self-destructive behavior", "self-mutilating behavior", "older adults", "geriatric population", and "nursing homes". The term "self-harm behavior" which also appears in the literature is broader in scope than "self-injurious behavior". It encompasses high suicide intent and failed suicide attempts; therefore, we excluded this term in order to focus purely on "self-injurious behavior". Our search yielded 10 publications concerning SIB in older adults, four of which included studies investigating SIB in nursing homes.
  
  
  RESULTS
  Clinical studies of SIB in older adult nursing home residents are sparse. This limited literature suggests that SIB is a prevalent phenomenon and is reported to be as high as 14% in one study of nursing home subjects aged 65 and older. It is reported to be strongly associated with dementia and a risk of accidental death. It has been suggested that SIB among demented patients occurs in the context of poor impulse control and physical isolation.
  
  
  CONCLUSIONS
  SIB is likely a common phenomenon in older adult nursing home residents. There is little evidence-based treatment guidance for SIB in older population.
authors.affiliation: Weill Medical College of Cornell University, Westchester Division, 21 Bloomingdale Rd, White Plains, New York 10605, USA. nam2024@med.cornell.edu
authors.forename: Nahla
authors.initials: N
authors.lastname: Mahgoub
authors.forename: Sibel
authors.initials: S
authors.lastname: Klimstra
authors.forename: Nabil
authors.initials: N
authors.lastname: Kotbi
authors.forename: John P
authors.initials: JP
authors.lastname: Docherty
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D003430:Cross-Sectional Studies; D003704:Dementia / Q000150:complications*; D005260:Female; D006801:Humans; D008297:Male; D009735:Nursing Homes / Q000706:statistics & numerical data*; D015995:Prevalence; D012307:Risk Factors; D016728:Self-Injurious Behavior / Q000453:epidemiology* / Q000209:etiology