Self-inflicted burns: a case series.
Self-inflicted burns are regularly admitted to burns units worldwide. Most of these patients are referred to psychiatric services and are successfully treated however some return to hospital with recurrent self-inflicted burns. The aim of this study is to explore the characteristics of the recurrent self-inflicted burn patients admitted to the Royal North Shore Hospital during 2004-2011. Burn patients were drawn from a computerized database and recurrent self-inflicted burn patients were identified. Of the total of 1442 burn patients, 40 (2.8%) were identified as self-inflicted burns. Of these patients, 5 (0.4%) were identified to have sustained previous self-inflicted burns and were interviewed by a psychiatrist. Each patient had been diagnosed with a borderline personality disorder and had suffered other forms of deliberate self-harm. Self-inflicted burns were utilized to relieve or help regulate psychological distress, rather than to commit suicide. Most patients had a history of emotional neglect, physical and/or sexual abuse during their early life experience. Following discharge from hospital, the patients described varying levels of psychiatric follow-up, from a post-discharge review at a local community mental health centre to twice-weekly psychotherapy. The patients who engaged in regular psychotherapy described feeling more in control of their emotions and reported having a longer period of abstinence from self-inflicted burn. Although these patients represent a small proportion of all burns, the repeat nature of their injuries led to a significant use of clinical resources. A coordinated and consistent treatment pathway involving surgical and psychiatric services for recurrent self-inflicted burns may assist in the management of these challenging patients.
Department of Plastic and Reconstructive Surgery, University of Sydney, Royal North Shore Hospital, Reserve Rd, St Leonards, NSW 2065, Australia. drafhenderson@yahoo.com.au
Antony
A
Henderson
Aruna
A
Wijewardena
Jeff
J
Streimer
John
J
Vandervord
D000293:Adolescent; D000328:Adult; D002056:Burns / Q000209:etiology*; D005260:Female; D006801:Humans; D001523:Mental Disorders / Q000150:complications*; D012008:Recurrence; D012189:Retrospective Studies; D016728:Self-Injurious Behavior / Q000523:psychology*; D055815:Young Adult