Self-mutilation: a systematic review

Area of Science:

• Medical Diagnostics
• Psychiatry
• Dermatology

Background:

• Self-mutilation lesions present diagnostic difficulties for healthcare professionals.
• Patients often do not admit to self-harm, leading to misdiagnoses.
• The condition's presentation can mimic other dermatological or traumatic injuries.

Purpose of the Study:

• To review the current literature on self-mutilation injuries.
• To identify epidemiological patterns, clinical presentations, and associated factors.
• To emphasize the link between self-mutilation and mental disorders.

Main Methods:

• Systematic literature search of PubMed, Periódicos Capes, Scopus, Science Direct, and WoS databases.
• Inclusion criteria: English, Portuguese, or Spanish articles from 2018 to June 2023.
• Study types included case reports, case series, and literature reviews.

Main Results:

• Men are slightly more affected, exhibiting more severe lesions, particularly on arms and external genitalia, often using knives.
• Self-mutilation injuries are reported globally, with higher incidence in Asia and the Americas.
• A clear association exists between self-mutilation injuries and mental disorders, frequently undiagnosed, with greater diagnosed mental health issues noted in women.

Conclusions:

• Self-mutilation injuries require heightened clinical suspicion due to diagnostic challenges.
• The underreporting in men may stem from lower demand for specialized treatment.
• Early identification and management of associated mental health conditions are crucial for effective treatment.