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Varieties of Pathological Self-mutilation.

A R Favazza1, R J Rosenthal2

  • 1Department of Psychiatry, University of Missouri, Columbia, Missouri 54201, USA.

Behavioural Neurology
|February 4, 2014
PubMed
Summary
This summary is machine-generated.

Pathological self-mutilation is a symptom and syndrome. Research differentiates stereotypical self-harm linked to developmental disorders from skin cutting/burning associated with personality disorders and a new impulse disorder.

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Area of Science:

  • Psychiatry
  • Clinical Psychology
  • Neuroscience

Background:

  • Pathological self-mutilation presents as both a non-specific symptom and a distinct syndrome.
  • Severe self-harm, including eye enucleation and amputation, necessitates high-risk patient identification.
  • Stereotypical self-mutilation (e.g., head banging, finger biting) is linked to intellectual disability and specific genetic syndromes.

Purpose of the Study:

  • To differentiate between various forms of pathological self-mutilation.
  • To explore biological underpinnings of stereotypical self-mutilation.
  • To identify diagnostic criteria for Repetitive Self Mutilation (RSM).

Main Methods:

  • Literature review and clinical case analysis.
  • Examination of associations between self-mutilation types and psychiatric conditions.
  • Exploration of biological research on neurotransmitters in stereotypical self-harm.

Main Results:

  • Stereotypical self-mutilation is associated with intellectual disability and syndromes like Lesch-Nyhan, deLange, and Tourette, with research focusing on endorphins and dopamine.
  • Skin cutting and burning, the most prevalent forms, correlate with personality disorders, PTSD, and dissociative disorders.
  • A new Axis I impulse disorder, Repetitive Self Mutilation, is identified, characterized by direct self-harm, eating disorders, and episodic alcoholism.

Conclusions:

  • Self-mutilation is a complex phenomenon requiring differential diagnosis.
  • Understanding the distinct etiological factors and associations of different self-mutilation types is crucial for effective treatment.
  • The recognition of Repetitive Self Mutilation offers a new diagnostic framework for a specific subset of patients.