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Acute management of the self-cutter
Archives of Emergency Medicine
|March 1, 1987
Summary
Self-cutting, a frequent emergency, often involves young, unemployed men with a history of psychiatric issues and high suicidal risk. Management requires careful assessment for psychiatric referral, as injury severity doesn't always correlate with risk.
Area of Science:
- Emergency Medicine
- Psychiatry
- Public Health
Background:
- Self-cutting is a significant emergency presentation in accident and emergency departments.
- Understanding the demographics and risk factors of self-cutting patients is crucial for effective management.
Purpose of the Study:
- To characterize individuals presenting with self-cutting injuries.
- To identify key factors influencing management decisions, particularly psychiatric referral.
Main Methods:
- A 6-month prospective study of all self-cutting cases presenting to Sheffield accident and emergency departments.
- Data collection on patient demographics, psychiatric history, and assessed suicidal risk.
Main Results:
- Self-cutting patients are predominantly young, unemployed men, a group at higher risk for repeated self-harm.
- A significant proportion (45%) have a prior psychiatric history, and 25% are deemed high suicidal risk.
- The severity of physical injury does not consistently correlate with the level of suicidal risk.
Conclusions:
- Acute management of self-cutting necessitates a formal assessment of psychiatric status and suicidal risk.
- Specialist psychiatric referral should be based on comprehensive assessment, analogous to managing complex physical injuries.