Preventing wounds from healing: clinical prevalence and relationship to borderline personality

In medico-economic studies, wound care has been shown to be expensive but is seemingly unavoidable given an aging population and the high community rates of diabetes and obesity. Astonishingly, however, some impaired wound resolution is intentional or purposeful. According to our review of seven clinical samples, the prevalence of preventing wounds from healing varies from 0.8 percent in a cardiac-stress-testing sample to 13.3 percent in a psychiatric inpatient sample. These variations in prevalence suggest that the more psychiatric loading in a given population, the higher the potential rate of preventing wounds from healing. In addition, statistical analyses indicate that preventing wounds from healing is consistently associated with borderline personality disorder. This link is most likely explained through the psychodynamics of self-harm behavior. Self-harm behavior is an inherent feature of borderline personality disorder, and preventing wounds from healing may be a self-injury equivalent among some patients with this particular personality dysfunction. Among participants with this Axis II disorder, women tend to report higher rates of preventing wounds from healing than men. Overall findings suggest that clinicians need to be alert to unexpected delays with wound healing, particularly in patients with psychiatric histories, and consider that such behavior is likely to be associated with borderline personality disorder.