The phenomenology of self-mutilation in a general hospital setting

Comparison of a series of twenty-four wrist-cutters with a control group of self-poisoners showed a number of significant differences. The wrist-cutters were younger and their acts were regarded as being of low lethality; they are no more likely to have made previous suicide attempts; they complain less often of depression, and more frequently of 'emptiness' and tension as primary complaints. Sudden, unpredictable mood swings are common and there is a greater tendency for their physicians to diagnose personality disorders, often in pejorative terms. They frequently have substantial medical interests and paramedical occupations. A high proportion complain of dysorectic symptoms (anorexia or overeating or combinations of both), use drugs and/or alcohol in excess; show sexual disturbance and distress, and also promiscuity. They more frequently have a negative reaction to menarche and menstruation; have come from broken homes and have experienced parental deprivation. A proportion of the group exhibit difficulty in verbal communication, and absconding from hospital was more common in the group of cutters. Painless cutting after a period of depersonalization, followed by relaxation and repersonalization after bleeding, was the typical pattern.